With the social and economic development, China now has more than 11% of the population over 60 years old and more than 10% of the population over 65 years old, and according to the international community standards, China has crossed the threshold of an aging society. By 2050, the total number of aged people over 60 and 65 in China will reach 450 million and 335 million respectively, which means that there will be 1 elderly person in every 3 people. As human life expectancy increases, the risk of osteoporosis (OP) further increases. Based on what we have learned in our clinical work and our knowledge of TCM health care, we have summarized our experience in graded prevention to prevent hip fractures in the elderly.
The spirit of Chinese medicine on health and disease prevention has been elaborated as early as in the Yellow Emperor’s Classic of Internal Medicine, such as “The ancient people, who knew the law of yin and yang, the harmony of the arts and figures, the regulation of diet, the regularity of rising and living, and the absence of delusional labor, were able to be in shape and in spirit, and to end their natural life only, and to live for a hundred years before leaving.” The main spirit includes regulating the spirit and mood, adapting to the four seasons, regulating diet and living, paying attention to the combination of work and rest, and advocating physical exercise and other aspects. Chinese medicine emphasizes the basic requirement of maintaining the dynamic balance of yin and yang in the human body, emphasizing the integral connection between the internal and external aspects of the “Heaven and Man”, as well as the decisive role of accumulating the essence of the whole spirit and strengthening the positive energy. This positive idea of disease prevention and anti-decay has laid the theoretical foundation for preventive medicine in TCM.
Primary prevention is “prevention before illness”.
(1) Regulating the spirit: In the first book of the Huangdi Neijing, the “Treatise on the Ancient Heavenly Truth”, there is a passage that says: “If you are calm and void, your true energy will follow it, and if you guard your spirit, you will be safe from illness. . It means that if one can maintain a peaceful state of mind and be in a relaxed mood, and keep the essence and spiritual energy in the body and not to leak out, then what disease is there?
(2) regulate diet: cultivate and adhere to good habits, reasonable meals, balanced nutrition, elderly people, especially women after menopause, should increase the intake of calcium, control weight, reduce obesity, quit smoking, limit alcohol, etc.
(3) reasonable exercise: such as increasing outdoor activities, reasonable exposure to sunlight, scientific fitness (such as five-animal play, taijiquan, qigong, eight-danjin, walking, etc.), weight-bearing exercises adapted to different ages.
(4) Regularity of living: respond to the four seasons of climate change, regularity of life and living, no delusional work.
(5) Reasonable use of drugs and active prevention of secondary osteoporosis: In addition to proper prevention and treatment of primary diseases, when drugs that can cause osteoporosis and other side effects (such as glucocorticoids, heparin, anti-epileptic drugs, etc.) must be used in the treatment of certain diseases, caution should be exercised and appropriate amounts should be taken, and corresponding measures should be taken to prevent the occurrence of osteoporosis and other complications.
(6) Active Chinese medicine prevention and treatment: In terms of the pathogenesis and healing of fracture, Chinese medicine recognizes that the kidney is the master of bone and the liver is the master of tendon, and if the liver and kidney are deficient, the tendon and bone will not be firm and fracture will easily occur; on the other hand, fracture must move internally in the kidney and damage the kidney essence, so the principle of Chinese medicine pre-treatment of fracture is mostly based on tonifying the kidney and filling the essence to strengthen the bone.
Secondary prevention is the early treatment of diseases and prevention of changes in existing diseases.
Through investigation and bone density screening, early detection, early diagnosis and early treatment, strengthening the supervision and health guidance for people prone to osteoporosis, relieving bone pain, improving health, delaying aging and improving the quality of life through pharmacological and non-pharmacological means.
In the treatment, we actively apply proven herbal medicines to nourish the liver and kidney as well as to tonify the qi and activate the blood.
Tertiary prevention is comprehensive prevention and control, focusing on the prevention of fractures.
(1) Prevention of osteoporosis: pay attention to balanced nutrition, obtain sufficient calcium to ensure bone mass; pay attention to exercise to improve bone metabolism and secure good bone structure.
(2) Treatment of osteoporosis and prevention of re-fracture.
(①Medication.
(ii) Calcium-containing foods (dairy products, beans, vegetables, shrimp and other seafood).
(3) Adequate sunshine and moderate exercise.
(3) Eliminate non-skeletal factors that cause fractures.
(i) Pay attention to safety in daily activities and avoid falls.
(ii) Choose appropriate exercise methods to avoid injuries.
(3) Create a good living environment and lighting facilities.
④ dress generously and loosely for easy movement.
⑤Adjust medication and maintain a good mental state.
⑥Someone should take care of the elderly when they go out.
(7) Take comprehensive measures for patients with osteoporosis to improve muscle strength and vision, improve balance and reaction ability, prevent bumps, falls and fractures.