中医药防治原发性骨质疏松症专家共识(2015)

Expert consensus on the prevention and treatment for primary osteoporosis with traditional Chinese medicine

中国老年学学会骨质疏松委员会中医药与骨病学科组在前期原发性骨质疏松症临床实践指南和专家共识的基础上,检索和评价相关文献资料,通过临床医师的问卷调查和学科组讨论,结合临床实际情况,并咨询我国中医骨伤科界名老专家意见,制定本共识,旨在为中医学或中西医结合医学专业医师提供参考。共识提出:根据原发性骨质疏松症的中医病因病机,辨证分为肾阳虚证、肝肾阴虚证、脾肾阳虚证、肾虚血瘀证、脾胃虚弱证和血瘀气滞证,明确相应治法和中药方剂;原则是"辨证施治,整体调节,防治结合",合理选择治疗方案、观察指标和检测项目,关注长期用药的安全性,以及临床疗效评价与监测;并强调预防原发性骨质疏松症"未病先防、既病防变、瘥后防复"的原则与方法,充分发挥中医学的特色和优势。

Based on the previous clinical practice guideline and expert consensus of primary osteoporosis （OP） , the searching and evaluating of the traditional Chinese medicine （TCM） literatures, the questionnaire surveys of clinicians and expert discussion, the situation of clinical practice, and the expert consulting of traditional medical traumatology and orthopedics, the Traditional Chinese Medicine and Osteopathy Group of the Osteoporosis Committee of China Gerontological Society formulates the consensus. It provides references for the clinicians of TCM or integrated TCM and Western Medicine. According to TCM etiology and pathogenesis of primary OP, types of syndrome of OP can be divided into kidney Yang deficiency syndrome, liver and kidney Yin deficiency syndrome, spleen and kidney Yang deficiency, blood stasis and kidney deficiency syndrome, asthenia of the spleen and stomach syndrome, blood stasis and Qi stagnation. The aim is to confirm the present therapy and Chinese medicinal formulas. The principle is ＂treatment based on syndrome differentiation, integral adjustments, and combination of prevention and treatment＂. It needs to select the treatment plan, observation and testing items rationally and to pay attention to the long-term medication safety and the evaluation and monitoring of clinical efficacy. It also needs to emphasize the principle and methods of prevention of primary OP, i. e. , ＂prevention before occurrence of the disease, prevention deterioration after occurrence of the disease, prevention of the recrudescence of the disease＂. And fully it needs to exert characteristics and advantages of traditional Chinese Medicine.