Osteoporosis (osteoporosis syndrome) is a systemic bone disease in which the bone mass of normal adults decreases with age, so older adults often have physiological osteoporosis. Osteoporosis is a manifestation of aging. If osteoporosis is accompanied by fractures, significant back pain or neurological symptoms, it should be considered a disease. Etiology: 1. Endocrine factors: Estrogen can stimulate osteoblasts and produce bone matrix. If the estrogen level decreases, the activity of osteoblasts decreases and bone formation decreases. Estrogen deficiency may be the cause of postmenopausal osteoporosis. Hyperthyroidism can cause and aggravate osteoporosis, and postmenopausal women with hyperthyroidism will have earlier and more severe osteoporosis. Glucocorticoids can inhibit the reabsorption of mineral salts by the renal tubules, causing an increase in urinary calcium, urinary phosphorus and urinary magnesium, resulting in a decrease in serum calcium, magnesium and inorganic phosphorus levels, seeking to negative nitrogen, negative calcium balance, inhibit bone formation and increase bone resorption. 2, nutritional factors: the maintenance of bone mass largely depends on nutrition and mineral salt supplementation, protein and calcium is particularly important. Decreased calcium intake, malabsorption and increased excretion are the main causes of negative calcium balance. Long-term protein deficiency results in lower plasma protein, insufficient synthesis of bone matrix protein, and lagging new bone production. Vitamin C is indispensable for the synthesis of bone matrix hydroxyproline, and if it is lacking, the synthesis of bone matrix can be reduced. Alcohol consumption can reduce calcium intake and increase urinary calcium excretion, and excessive caffeine intake can also cause urinary calcium and endogenous fecal calcium loss. 3, waste factors: the size of the bone and mechanical load is closely related. The greater the load, the more developed the bones. Various causes of disuse such as plaster fixation, paralysis or severe arthritis, due to inactivity, no weight bearing, the mechanical stimulation of the bone is reduced, so osteoporosis occurs. 4, genetic, immune factors : osteogenesis imperfecta, homocystinuria clinically manifested as deformities of the spine and lower limbs, osteocytopenia, embolic lesions. Rheumatoid arthritis is often accompanied by atrophy of connective tissue, including skeletal collagen tissue, if there is a further loss of use or application of glucocorticoid therapy is more likely to cause osteoporosis. The bone mass of men and women begins to decline after the age of 35 to 40, and women lose much more bone mass than men after menopause, so the incidence is much higher in women than in men. Symptoms: The onset of osteoporosis is slow, and the clinical manifestations are generally mild or only low back pain. Patients are most often seen with fractures, usually without obvious trauma or with minor injuries. A sudden increase in pain in the patient’s low back is indicative of a possible fracture. Patients report that they may have spasm of the low back muscles and are afraid to move. Minor movements such as coughing and defecation can cause unbearable pain. A few patients may have respiratory impairment due to thoracic deformity and reduced rib movement during breathing, which affects cardiopulmonary function. In early stages and in patients with mild symptoms, there may be no obvious signs. After fracture, patients may have hunchback, scoliosis deformity, significant shortening of the spine, and the lower edge of the ribs is close to the iliac crest. The muscles of the lower extremities often have different degrees of atrophy. Western medical treatment: (1) Acute treatment: Once the vertebral body is fractured, it is necessary to rest on a hard bed with a pillow under the knee to reduce the stress on the lower back. Pay attention to bedsore care. You can use some painkillers, and after the pain disappears, you should start exercising and increase the activity day by day. If the pain is severe, a brace can be worn. (2) Methods to increase bone tissue: ① Oral calcium: calcium carbonate, calcium phosphate, calcium lactate, calcium gluconate can be applied. Drinking more water should be encouraged after taking oral calcium to prevent urinary tract stones. ② Vitamin D supplementation: It must be noted that large doses of vitamin D supplementation can cause hypercalcemia. ③ Periodic application of sex hormones For women around the time of menopause. Hexenoestradiol or 17βestradiol: 0.5-1.0mg/day, continuous daily dose, discontinued for 1 week after 4 weeks, combined with progesterone during the discontinuation period; the general course of treatment should not exceed 2-3 years, but endometrial proliferation and functional uterine bleeding and induction of cervical cancer should be frequently noted, so gynecological and vaginal smear cytology should be performed regularly during the drug administration. ④Exercise:At least 30min of walking is required daily, both to exercise under weight and to absorb light. ⑥Calcitonin General dose force 50-100IU per day, can reduce bone resorption, should be used in combination with calcium, its side effects are small, occasionally nausea, vomiting. Chinese medicine treatment: (1) Kidney essence deficiency: Treatment: nourish liver and kidney, strengthen tendons and bones. The formula: Zuo Gui Wan and Hu Qian Wan plus or minus. In the formula, rehmannia, tortoise board, dogwood, cuscuta, white peony nourish yin and nourish deficiency, nourish liver and kidney yin; lock yang, deer gum warm yang and benefit essence, nourish tendons and moisten dryness; Chinese wolfberry benefit essence and brighten eyes; yellow cypress, Zhi Mu diarrhea fire and clear heat; tiger bone (tiger bone is not used now, can be replaced by cow bone), cow knee strengthen the waist and knee, strengthen tendons and bones; yam, Chen Pi, dry ginger warm the middle and strengthen the spleen. For joint pain or fever, add turtle nail, Di Long, Gentiana macrophylla, and Sang Zhi; for bone vapor and hot flashes, replace Shu Di with Sheng Di, add Artemisia annua, Yin Chai Hu, and Hu Huang Lian; for muscle and vein constriction, add Mu Gua, Han Fang Ji, Luo Shi Vine, and Sheng Gan Cao; for children who are easily frightened and convulsed with sweating, add oyster, keel bone, and hooked vine; for muscle and joint tingling, refusal to press or hard nodules, skin petechiae, dryness, dark face and lips, pale purple tongue or petechiae, and stringent and astringent pulse, etc. If there are manifestations of blood stasis, we can use Blood Mansion and Blood Stasis Tang with Fuyuan and Blood Activation Tang plus reduction to nourish the blood and activate the blood, activate the ligaments and soften the firmness. (2) Qi deficiency of spleen and kidney: Treatment: tonifying the spleen and kidney. Treatment: tonifying the spleen and kidney. In the formula, the system of spleen and kidney qi is supplemented by the fructus sanguinis and the flesh of meat to strengthen the kidney qi. For abdominal pain and anxiety, add Wu Tau, Hsiang Hsiang, Quan Scorpion, Centipede; for swelling of the joints, add Poria, Ze Di, Coix Seed, for fatigue, add Astragalus; for muscle atrophy, add Ganoderma lucidum, He Shou Wu, Chicken Blood Vine, Agaricus. For patients with osteoporosis combined with deformity or fracture, use splint or brace to fix and brake, and encourage patients to perform appropriate functional exercises early. Prevention: Develop good dietary and living habits to keep the bone mass relatively stable and reduce its loss. Regular active exercise, appropriate load, avoid excessive smoking, cooking alcohol, taking too much caffeine, reasonable nutrition, higher calcium intake, such as consumption of milk, soy products, fish, shrimp and crab. The use of drugs or nutrients that affect the utilization of calcium should be controlled, such as acidophilus containing aluminum, and those on a long-term strict vegetarian or low-salt diet should pay more attention to calcium supplementation. Small doses of estrogen therapy can be considered for post-menopausal women.