Osteoporosis is a systemic bone disease characterized by low bone mass and destruction of bone microarchitecture, leading to increased bone fragility and susceptibility to fracture (World Health Organization, WHO). It is mostly seen in postmenopausal women and older men. Primary and secondary osteoporosis are divided into three types: postmenopausal (type I), senile (type II) and idiopathic (type III) osteoporosis. The postmenopausal type mostly occurs within 5 to 10 years after menopause in women, and osteoporosis occurring after the age of 70 is generally referred to as senile osteoporosis. Risk factors for the disease include: low body weight, low sex hormones, smoking, excessive alcohol consumption, coffee and carbonated beverages. Lack of physical activity, low calcium content in the diet and low sun exposure can also contribute to osteoporosis.
Pain, spinal deformities and fractures are typical clinical manifestations of osteoporosis. The spine, shoulder, hip, wrist and ankle are the common sites for osteoporotic fractures (fragility fractures). Due to the decrease in bone strength, fractures can occur with minor trauma or during daily activities, and are a serious consequence of osteoporosis.
Osteoporotic fractures greatly increase the disability and mortality rates in the elderly. Therefore, prevention of osteoporosis is more important than treatment. The primary and ultimate goal of prevention and treatment of osteoporosis is to avoid the occurrence of fractures.
Preventing and treating osteoporosis in daily life should pay attention to.
1.Eating foods rich in calcium, low salt and moderate amount of protein.
2. appropriate outdoor activities, participation in physical exercise (walking, etc.) and rehabilitation that contribute to bone health
3, quit smoking, limit alcohol and careful use of drugs that affect bone metabolism, etc.; strengthen protective measures for yourself and the environment to prevent falls, etc.
Drugs include.
1.Calcium supplements.
2.Active vitamin D.
3.Drugs to inhibit bone resorption.
4.Chinese medicine, etc.
Calcium intake slows bone loss and improves bone mineralization. When used for the treatment of osteoporosis, calcium should be used in combination with other drugs. The right amount of active vitamin D can promote bone formation and mineralization, and inhibit bone resorption, improve bone density, enhance muscle strength and balance in the elderly, and reduce the risk of falls.
Drugs that inhibit bone resorption are.
1, bisphosphonates.
2, Calcitonin class.
3.Selective estrogen receptor modulators (SERMs).
Among them, bisphosphonates can effectively inhibit osteoclast activity and reduce bone turnover. Calcitonin class can inhibit the biological activity of osteoclasts and reduce the number of osteoclasts, prevent bone loss and increase bone mass. SERMs are effective drugs for the prevention and treatment of postmenopausal osteoporosis.
According to TCM, the disease is characterized by deficiency of kidney essence and deficiency of spleen and kidney qi as the root cause and stasis of blood blocking the ligaments as the symptoms. The clinical use of Tonic Zheng Xuan Bone Pill, Liu Wei Di Huang Pill, Right Return Pill and Body Pain and Stasis Removal Soup is effective in tonifying the kidney and strengthening the bones, strengthening the spleen and benefiting the qi, and activating blood circulation. Combined with external treatment such as Chinese herbal fumigation, the treatment can help to relieve inflammation and analgesia, so as to treat both the symptoms and the root cause.
The principle of treatment for osteoporotic fracture is to help patients leave bed as soon as possible, resume daily life and reduce the disability rate.