绝经后骨质疏松症的预防和药物联合序贯治疗

Prevention and sequential therapies combined with drugs for postmenopausal osteoporosis

背景:绝经期后的妇女由于雌激素水平下降导致骨吸收迅速增加,造成骨吸收和形成之间的不平衡,增加了骨质疏松和相关部位骨折的风险。然而,目前的临床防治并不足以抑制长期的骨丢失和不断增加的骨折风险。近年来,针对绝经后骨质疏松症及时有效的预防和抗骨质疏松药物序贯联合治疗已成为必然趋势。目的:就绝经后骨质疏松症的预防和抗骨质疏松药物治疗的相关文献进行总结,介绍绝经后骨质疏松症的临床预防措施和常见的抗骨质疏松药物联合序贯治疗进展。方法:作者于2020年1月应用计算机检索2009年1月至2019年12月中国期刊全文数据库CNKI、万方和PubMed数据库的相关文章,中文检索词"绝经后骨质疏松症,预防,药物,治疗";英文检索词"Postmenopausal osteoporosis,prevention,drug therapy,medication",根据纳入标准及排除标准摘选41篇文章进行分析讨论。结果与结论:①绝经后妇女要及时进行骨密度测试,通过改变饮食结构和生活方式进行预防,以降低骨折风险;②与单一药物相比,联合序贯疗法可以更有效地治疗绝经后骨质疏松症,对绝经后骨质疏松症的治疗具有深远的意义。

BACKGROUND: In postmenopausal women, a rapid increase in bone resorption due to decreased estrogen levels leads to an imbalance between bone resorption and bone formation, increasing the risk of osteoporosis and associated fractures. However, current clinical interventions are not sufficient to inhibit long-term bone lossand increased risk of fracture. In recent years, it has become an inevitable trend to treat postmenopausal osteoporosis with timely and effective prevention and sequential combination of anti-osteoporosis drugs. OBJECTIVE: To summarize the literature on the prevention of postmenopausal osteoporosis and the anti-osteoporosis drug therapy, and introduce the progress of the clinical preventive measures and the common anti-osteoporosis drug combination sequential treatment of postmenopausal osteoporosis. METHODS: The author retrieved the relevant articles in CNKI, Wanfang and Pub Med databases from January 2009 to December 2019 in January 2020. The search words were "postmenopausal osteoporosis, prevention, drug therapy, medication" in Chinese and English respectively. Finally, 41 articles were selected according to inclusion and exclusion criteria for analysis and discussion. RESULTS AND CONCLUSION:(1) Postmenopausal women should receive the test of bone mineral density and osteoporosis was prevented by changes in diet and lifestyle to reduce the risk of fractures.(2) Compared with single drugs, combination with sequential therapies can be more effective in the treatment of postmenopausal osteoporosis, which has far-reaching significance for the treatment of postmenopausal osteoporosis.