China is the country with the largest number of patients with osteoporosis, with about 100 million people suffering from the disease. The incidence rate has jumped to the seventh place after cardiovascular and cerebrovascular diseases and cancer. With the extension of human life expectancy and the arrival of social aging, osteoporosis has become an important health problem for human beings. A nationwide epidemiological survey conducted in 2003-2006 showed that the total prevalence of osteoporosis over the age of 50 was 20.7% for women and 14.4% for men.
In contrast, the incidence of osteoporosis over the age of 60 was 56%, with concurrent fractures of up to 12%. The result of osteoporosis is a fracture, especially a fracture of the femoral neck of the hip, which is medically called the last fracture of life, because death in this area within one year after the fracture occurs is as high as 20%, and 25% of those who survive for more than one year will be disabled. According to survey estimates, in 2006, there were about 69.44 million people over the age of 50 suffering from osteoporosis, and about 210 million people had low bone mass.
It is estimated that the rate of hip fractures due to osteoporosis in China will increase significantly in the coming decades. The lifetime risk of osteoporotic fracture in women (40%) is higher than the combined risk of breast, endometrial, and ovarian cancers.
From the above, it is clear that, in fact, osteoporosis is a degenerative disease and that the risk of developing it increases with age.
Severe consequences of osteoporosis :
A serious consequence of osteoporosis is the occurrence of osteoporotic fractures (fragility fractures), i.e. fractures that can occur during minor trauma or during daily activities. Common sites for osteoporotic fractures are the spine, hip, and distal forearm. Uncle Lee is an example. Osteoporotic fractures are very dangerous and lead to increased disability and mortality. For example, within one year after a hip fracture occurs, 20% of people die from various complications, while about 50% of survivors are disabled and cannot take care of themselves, and their quality of life is significantly reduced. Moreover, the treatment and care of osteoporosis and its fractures require huge human and material resources and are expensive, causing a heavy family, social and economic burden!
It is urgent to educate the public about the health of osteoporosis and to make them aware of and prevent osteoporosis!!!
First, we know what osteoporosis is.
I. Origin: osteoporosis, was proposed by Pornmer in 188 5, people’s understanding of osteoporosis is gradually deepened. In the early years, it was generally considered that the reduction of bone mass in the whole body is osteoporosis, and in the United States, it was considered that fracture in old age is osteoporosis. It was not until the 3rd International Symposium on Osteoporosis held in Denmark in 1990 and the 4th International Symposium on Osteoporosis held in Hong Kong in 1993 that osteoporosis was given a clear definition and recognized worldwide: primary osteoporosis is a systemic bone disease characterized by a decrease in bone mass and degeneration of bone microstructure, resulting in an increase in bone fragility and susceptibility to fracture. International Osteoporosis Day is celebrated on October 20 every year.
There are many causes of osteoporosis, but calcium deficiency is a widely recognized factor. Calcitonin and vitamin D deficiency are also important. It has also been suggested that the long-term loss of bone mass due to the long-term acidic state of fluids in the body is also a cause of osteoporosis.
Third, classification: osteoporosis is divided into two categories: primary and secondary. Primary osteoporosis is divided into three types: postmenopausal osteoporosis (type I), senile osteoporosis (type II) and idiopathic osteoporosis (including adolescent type). Postmenopausal osteoporosis generally occurs in women within 5-10 years after menopause; senile osteoporosis generally refers to osteoporosis occurring in the elderly after the age of 70; secondary osteoporosis refers to osteoporosis caused by any disease or drug that affects bone metabolism; and idiopathic osteoporosis mainly occurs in adolescents, the cause of which is still unknown
Performance: Pain, spinal deformation and fragility fracture are the most typical clinical manifestations of osteoporosis.
1, pain: low back pain is common, accounting for 70%-80% of the patients with pain. The pain spreads along the spine to both sides, decreases when lying on the back or sitting, increases when posterior stretching or prolonged standing or sitting in an upright position, is light during the day, increases at night and when waking up in the morning, and increases when bending, muscle movement, coughing and bowel exertion. Peripheral skeletal pain is second to none, and when the load increases (i.e., too much activity or prolonged sitting or standing), the pain worsens or activity is limited, and in severe cases, there are difficulties in turning over, sitting up, and walking. In addition, with osteoporosis, the loading capacity of the bone is reduced, and various activities and loads often rely too much on muscle, resulting in muscle strain, spasm, is also a trigger, aggravating the cause of pain.
2, spinal deformity: more after the pain appears. Severe cases may have shortened height and hunchback, spinal deformity and limited extension activities. Because the vertebrae of the spine are almost composed of cancellous bone and are the pillars of the body, the high weight-bearing, easy to compress and deform, so that the spine tilts forward and the dorsal curvature increases, forming a hunchback, and as we grow older, the osteoporosis increases and the hunchback curvature increases.
3, fracture: is a low-energy or non-violent fracture, such as daily activities can occur, that is, fragility fracture. Common sites are thoracic and lumbar spine, hip, forearm wrist and elbow joint upper fracture. In severe cases, compression fractures of the thoracic spine result in thoracic deformity and affect cardiopulmonary function. Fractures of the lumbar spine may alter the abdominal anatomy, causing constipation, abdominal pain, bloating, loss of appetite, and a feeling of premature fullness. Fractures may also occur in other areas. After a single fragility fracture, the risk of another fracture is significantly increased.
So, how is osteoporosis diagnosed?
The diagnosis of osteoporosis depends on a comprehensive analysis of clinical manifestations, bone mass measurement, X-ray and biochemical indicators of bone conversion. Some patients with osteoporosis have no obvious symptoms, bone measurement is particularly important, and combined with biochemical tests, the diagnosis is generally not difficult.
(I) Medical history and clinical features
The common points are: the peripheral bone pain is mainly in the spine, pelvic region and fracture site, which is persistent and parallel to the degree of osteoporosis, especially when stirring or position change. Long-term disease lower limb muscle atrophy vertebral compression fracture, resulting in length shortening; thoracic deformity, reduced lung capacity may affect cardiopulmonary function.
(B) bone mass assessment.
The main technical methods are: single-energy photon absorptiometry (SPA), dual-energy photon absorptiometry (DPA), dual-energy X-ray absorptiometry (DEXA), quantitative computed tomography (QCT), ultrasound, etc.
(C) Laboratory examination items
Blood and urine routine; liver and kidney function; calcium, phosphorus, alkaline phosphatase, serum protein electrophoresis, etc.
Patients with primary osteoporosis usually have blood calcium, phosphorus and alkaline phosphatase values in the normal range, and when there is a fracture, there is a mild increase in blood alkaline phosphatase levels. If abnormalities are found in the above tests, further examination or referral to the relevant specialist is required for further differential diagnosis. In addition, the following tests may be performed as appropriate for further differential diagnosis: blood sedimentation, gonadotropins, 25OHD, 1,25(OH)2D, parathyroid hormone, urinary calcium and phosphorus, thyroid function, cortisol, blood gas analysis, blood and urine light chain, tumor markers, and even radionuclide bone scan, bone marrow aspiration or bone biopsy.
There are also biochemical markers of bone conversion, which are the metabolic (catabolic and synthetic) products of bone tissue itself, referred to as bone markers, divided into bone formation markers and bone resorption markers. The former represents bone metabolites during osteoblast activity and bone formation, while the latter represents metabolites during osteoclast activity and bone resorption, especially bone matrix degradation products. The measurement of these indicators helps to determine the type of bone transformation, the rate of bone loss, the assessment of fracture risk, the understanding of disease progression, the selection of interventions, and the monitoring of treatment efficacy.
(iv) X-ray examination
X-ray plain film is the most common method to observe bone cortical thickness and trabecular morphology to determine osteoporosis. The disadvantage is that only a rough judgment can be made, only qualitative, not quantitative analysis, poor sensitivity, when the X-ray shows osteoporosis, the reduction of bone minerals has been more than 30%. It is especially obvious in the spine and pelvis, especially in the thoracic and lumbar spine during the weight-bearing stage.
How should osteoporosis be treated?
I. Modern medicine
Active treatment measures should be taken for patients with osteoporosis. The principles of treatment mainly include: slowing down the rate of bone loss and restoring the lost bone mass to relieve symptoms and prevent fractures and other complications.
(i) Acute phase: Once a vertebral body fracture occurs, it is necessary to rest in a hard bed with a pillow under the knee to reduce the stress on the lower back. Pay attention to decubitus ulcer care can use some painkillers, and after the pain disappears, you should start to exercise and increase the activity day by day; those with severe pain can wear a brace.
(ii) Methods to increase bone tissue.
1. oral calcium: calcium carbonate, calcium chloride, calcium lactate, calcium menthylate, calcium gluconate can be applied. after oral calcium intake, more water should be encouraged to prevent urinary tract stones. It is generally believed that adequate calcium supplementation can relieve pain and promote calcium balance. 2.
2. Vitamin D supplementation can promote the absorption of calcium in the intestine and promote calcium balance. Caution must be taken: high doses of vitamin D supplementation can cause hypercalcemia; the daily dose for pre- and postmenopausal women is 400 units.
3. Bone resorption inhibitors to reduce further bone loss: estrogen, calcitonin, diphosphonates, and isoproterenol are all in this category; A. Estrogen Estrogen has many adverse effects, is only suitable for women before and after menopause, has carcinogenic potential for long-term use, and should not be used as routine treatment. B. Calcitonin: such as mikacalcitol; C. Diphosphonates: such as fomesan, etc.
4. bone formation promoters to increase bone mass, including fluoride, vitamin K, parathyroid hormone, androgens, growth hormone, etc.
5. exercise: at least 30 minutes of walking every day, i.e., exercise under weight and absorb light.
Second, traditional Chinese medicine.
Ancestral medicine believes that the occurrence and development of this disease is closely related to the “kidney energy”. Suwen – five Tibetan generation chapter said: “the kidney, the bone also.” The “Su Wen – six sections of the Tibetan Elephant Theory” said: “The kidney, the main sting and hide the essence of the original, the place where the essence is also, its Hua in the hair, its full in the bone.” “The kidney is the master of the bone, collects the essence, the essence produces the marrow and yields the bone.” “The liver is the master of tendons and blood collection, the spleen is the master of muscles, limbs and blood unification, and the spleen is the master of transportation and transformation.” At the same time, the spleen is the origin of the posterior, the source of Qi and blood biochemistry, due to nutritional imbalance, spleen and stomach damage, no essence and blood to nourish the kidneys to fill the bones, can also cause this disease.
It can be seen that the deficiency of kidney essence is the main cause of osteoporosis, and the deficiency of spleen and kidney qi and blood is the source of Qi and blood, so there is no way to transform essence and produce marrow, and the marrow is withered and the bone is impotent, and the loss of harmony of the meridians also causes the disease. The main formulas are: Jin Kui Kidney Qi Pill, Wu Ji Bai Feng Pill, Nourishing Kidney and Fixing Chong Tang, Liu Wei Di Huang Pill, Gui Shen Pill and Hu Qian Wan. Commonly used herbal medicines include: Cistanches, He Shou Wu, Atractylodes, Zi He Che, Boneset, Huai Niu Knee, Cuscuta, Calcined Dragon Bone, Calcined Oyster, etc., which can effectively improve the symptoms of kidney deficiency and relieve back pain.
Local people are very concerned about “taboo”, the usual dietary taboos: 1.
1, it is appropriate to supply sufficient calcium. To eat calcium-rich foods, such as ribs, bones, shrimp, kelp, hairy vegetables, fungus, citrus, walnuts, etc.;
2, it is appropriate to supply sufficient protein, milk, eggs, fish, chicken, lean meat, beans and soy products, etc.;
3, should supply enough vitamin D and C, because it plays an important role in the regulation of bone metabolism. Should eat more fresh vegetables, amaranth, parsley, cabbage, but also eat more fruit;
4, avoid spicy, too salty, too sweet and other stimulating food.
In addition, after the occurrence of osteoporosis, in addition to formal drug treatment, reasonable dietary nutrition will also help improve the symptoms, there are several osteoporosis diet for your reference.
1, soybean pork bone soup: 250 grams of fresh pork bones, 100 grams of soybeans. Method: soy beans soak in water 6-8 hours in advance; wash the fresh pork bones, cut off, placed in water boiling, remove the blood; then put the pork bones into a casserole, add 20 grams of ginger, 200 grams of yellow wine, salt, add water 1000 ml, after boiling, cook with a civilian fire until the bone rotten, put soy beans continue to cook until the beans rotten, can be eaten. Once a day, 200 ml each time, 1 dose per week.
Effect: Fresh pork bones contain natural calcium, collagen, etc., which has a complementary effect on bone growth. Soybean contains flavonoid glycosides, calcium, iron, phosphorus, etc., which have the nutrients needed to promote bone growth and replenish bone. This soup has a good prevention of bone aging, osteoporosis effect.
2, mulberry cow bone soup: mulberry 25 grams, cow bone 250 ~ 500 grams. Wash the mulberry, add wine, sugar a little steam. Put the beef bones in a pot, boil water, skim off the froth after boiling, add ginger, onion and then cook. When the bones are white, the calcium, phosphorus and bone gum of the bones have been dissolved into the soup, then fish out the bones, add the steamed mulberry, remove the froth after boiling, season and drink.
Efficacy: mulberry liver and kidney; beef bones are rich in calcium and collagen, can promote bone growth. This soup can nourish Yin and blood, kidneys and tendons, especially for osteoporosis, menopausal syndrome, etc.
3, shrimp skin tofu soup: 50 grams of shrimp skin, 200 grams of young tofu. Method: shrimp skin washed and soaked; tender tofu cut into small squares; add scallions, ginger and wine, stirring in a frying pan and add water to boil soup.
Effectiveness: shrimp per 100 grams of calcium content up to 991 mg, tofu also contains high calcium, regular consumption of this soup on calcium deficiency of osteoporosis effective.
4, pigskin sequestra soup: 200 grams of fresh pigskin, sequestra 50 grams. Method: Take fresh pig skin, remove hair, fat, cut small pieces, put into a steamer, add 15 grams of ginger, 100 grams of yellow wine, salt; take the decoction of thick juice added to the pot, add the right amount of water, cooked over moderate heat until the pig skin rotten for the degree, can be eaten. 1 day 1 time, divided service.
Efficacy: pig skin is rich in collagen, collagen on the human cartilage, bones and connective tissue have an important role. Continuation: It has the effect of strengthening tendons and bones, benefiting the liver and kidney. This porridge is good for reducing the pain caused by osteoporosis and delaying the onset of osteoporosis.
Prevention
Preventive measures for osteoporosis can be summarized as: proper calcium supplementation, regular exercise and balanced diet. Specific measures include.
1.Balanced nutrition and proper calcium supplementation.
2.Promote physical exercise to increase adult bone reserves.
3.Actively treat diseases related to osteoporosis.
4.Protect liver and kidney function.
5.Prevent fractures.
Interested friends can try to do the following health exercises.
Waist rubbing gong is one of the folk fitness methods handed down from ancient times in China. Waist is connected to all parts of the body, the exhibition for the kidney House. Chinese medicine believes that the waist for the solar bladder meridian, the Governor’s vein over, massage the waist can improve the circulation of the body’s blood collection, has the cold to remove dampness, and harmonize the qi and blood. It has the effect of dispersing cold, removing dampness, harmonizing qi and blood, dredging the meridians, filling the kidneys and relieving pain. Improve the most part of the blood circulation, increase the elasticity of the waist, and then enhance the endurance of the waist muscle, activating the function of the lumbar vertebral joints. Therefore, waist rubbing is not only for fitness, but also for prevention of back pain. The main movements include rubbing, pinching, mo, buckling, grasping and spinning.
1.Rubbing
Sit upright with your feet open, shoulder-width apart. The two palms of the hands on the rubbing scattered ten times, to be hot, and then press both sides of the lumbar eye (the fourth lumbar vertebra spine protrusion around 3.5 inches each). After a short pause of about 3 to 5 breaths, two palms along the lumbar vertebrae on both sides, up and down hard pounding, down to the tailbone under the long strong point (between the tip of the tailbone and the anus), up to the two arms after the end of the flexion. 36 times in a row.
2, pinch
Both thumbs and index fingers pinch the skin in the middle of the spine, from the point of life parallel to the navel suck (under the spinous process of the second lumbar vertebra) downward pinch, pinch a little loose, until the tailbone. This chiropractic 4 times.
3.Mo
Both hands lightly clenched fist, fist eye up, with the prominent part of the palm knuckles, in both sides of the lumbar eye, for rotational massage, first in a clockwise direction, rotate 18 turns, and then in a counterclockwise direction, rotate 18 turns. Both sides can be carried out simultaneously. Can also be carried out first left and then right.
4.Button
Both hands lightly clenched fist, fist eye down, while using the palm surface of the two fists lightly buckle (to the degree of no pain) sacrum, left and right fist buckle 36 times each.
5.Grab
Both hands reverse fork the waist, thumb in front, press on the side of the waist does not move. The remaining four fingers from both sides of the lumbar vertebrae, with the finger belly outward grasp the skin. Both hands simultaneously, each grasping and rubbing 36 times.
6.Spin
Stand straight. Both feet open and shoulder width, both hands crossed waist (four fingers in front, thumb in the back).
(1) both hands push forward to make the abdomen protrude, the body to the back.
(2) Push the left hand hard to the right and bend the upper body to the left as much as possible.
(3) push backward with both hands, sit back hard at the hips, and bend forward with the upper body as much as possible. The above 4 movements for 1 circle. Rotate the waist in a clockwise direction for 9 turns, and then rotate counterclockwise for 9 turns.
(4) The right hand pushes hard to the left and bends the upper body as far as possible to the right.
Note that when rotating the waist should be slow, not too fast or too hard, so as not to sprain the waist. Practice is generally taken sitting position. When the indoor temperature is low, you can also be in bed covered with a supine position, but need a suave massage and then the other side. Rotating waist action can be performed standing in clothes.
Prevention is the main, the number of massage for each action can be reduced, generally within 36 times. If used for treatment can be increased to 60-120 times, to a slight sweat as the degree, so as not to overwork.