骨代谢调节剂参与骨关节炎的治疗:作用、问题及前景

Bone metabolic modulators for osteoarthritis: curative efficacy, problems and prospects

背景:骨关节炎是一种骨关节退化性疾病,主要表现为关节软骨退变和软骨下骨硬化,引起患者关节疼痛、功能下降。近年来,骨代谢调节剂对其治疗作用成为研究热点并应用于临床。目的:综述应用骨代谢调节剂对骨关节炎的作用机制和治疗效果。方法:由第一作者在PubM ed和CNKI等数据库中进行文献检索,关键词为"骨关节炎、骨代谢调节剂、骨质疏松、关节、治疗、甲状旁腺激素、降钙素、二膦酸盐、选择性雌激素受体调节剂"及"Osteoporotic,bone metabolic modulators,osteoarthritis,joint,PTH,CT"等,检索时间为2000年1月到2017年6月。广泛查阅国内外有关骨代谢调节剂对骨性关节炎的作用效果及作用机制的有关文献,并进行综述。结果与结论:骨代谢调节剂对骨关节炎关节具有保护作用,能够减缓骨关节炎软骨以及软骨下骨的破坏,稳定关节内环境,减轻骨关节炎样关节退变,阻止骨关节炎关节的破坏。此外,骨代谢调节剂联合非类固醇抗炎药可以减少相关药物的使用量,降低单一用药的不良反应,可能对骨关节炎的治疗具有更好的治疗效果。

BACKGROUND： Osteoarthritis is a degenerative disease of the joints, mainly characterized by degeneration of articular cartilage and subchondral bone sclerosis, resulting in joint pain and decreased function in patients. In recent years, bone metabolism modulators have become a research hotspot and applied in clinic. OBJECTIVE： To review the mechanism and curative efficacy of bone metabolic modulators for osteoarthritis. METHODS： The first author retrieved Pub Med and CNKI databases for relative articles published from January 2000 to June 2017. The keywords were ＂osteoporotic, bone metabolic modulators, osteoarthritis, joint, PTH, CT＂ in English and Chinese, respectively. The literature concerning the effects and mechanisms of bone metabolic modulators on osteoarthritis was extensively reviewed and comprehensively analyzed. RESULTS AND CONCLUSION： Bone metabolic modulators have potential protective effects on osteoarthritic joints, preventing cartilage and subchondral bone destruction, reversing osteoarthritis-like joints change and delaying the destruction of osteoarthritic joints. The bone metabolic modulators combined with non-steroidal anti-inflammatory drugs can reduce dosages of related medicines and decrease the side effects caused by single medicine, which may have better therapeutic effects.