绝经后骨质疏松症药物预防和治疗方案分析  

Drug prevention and therapeutic program of postmenopausal osteoporosis

作　　者：朱静芬[1] 谢庆文[1] 杨永彬[2] 

机构地区：[1]上海第二医科大学公共卫生学院全科医学教研室,上海市200025 [2]上海市第一人民医院妇产科,上海市200080

出　　处：《中国临床康复》2005年第11期148-149,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:通过对近年来绝经后骨质疏松症药物预防和治疗试验研究现状的总结,以探讨绝经后骨质疏松症postmenopansalosteoporosis,PMO的()有效预防和治疗方法。资料来源:应用计算机检索Medline1995-01/2004-09关于绝经后骨质疏松症和药物干预方面的文章,检索词为“Osteoporosis,Post-menopausal,preventionandcontrol,bonedensity,fractures”,并限定语言种类为English,研究对象为绝经早期或绝经期女性,文章类型为随机对照研究。资料选择:对资料进行初审,选取试验包括干预组和对照组的文献,筛除明显不随机的研究,对剩余的文献开始查找全文,进一步判断为随机对照实验。纳入标准为①随机对照实验,采用单盲,双盲或非盲法。②试验包含平行对照组。③干预研究时间1年以上者。④研究样本量大于100人。排除标准:重复性研究及非药物干预研究。资料提炼:共收集到77篇关于绝经后骨质疏松症的随机对照研究的文章,其中9个试验为药物干预研究且持续时间为1年以上。排除的68篇为非药物的干预研究、重复试验或理论探讨。资料综合:9个试验包括使用双膦酸盐、激素替代疗法、钙剂、选择性雌激素受体调节剂等药物干预方法和非药物干预措施介入来预防和治疗绝经后骨质疏松。钙、维生素D及其衍生物虽然只有轻微的抗骨质吸收作用对?OBJECTIVE: To summarize the present status of study on the drug prevention and therapeutic trials of postmenopausal osteoporosis (PMO) in recent years, so as to investigate the effective prevention and treatment for PMO.DATA SOURCES: An online search of Medline database was undertaken by using the keywords of “ osteoporosis, postmenopausal, prevention and control, bone density, fractures' to identify the articles about PMO and drug interventions published in English from January 1995 to September 2004. The subjects were females of early menopause or menopause, and the articles should be randomized controlled study.STUDY SELECTION: After the above search, the trials including intervention and control groups were selected, while the obvious non randomized trials were excluded, and then the full texts of the selected articles were scanned for randomized controlled study. Inclusion criteria: ① randomized controlled study with single blind, double blind or non blind method; ② experiments including parallel control groups; ③ interventional period was above 1 years; ④ samples were more than 100. Exclusion criteria: repetitive experimental study and non drug intervention.DATA EXTRACTION:Seventy seven articles of randomized control study about PMO were collected, 9 of them were trials of drug intervention lasted for more than 1 year. The 68 excluded articles were non drug interventional studies, repetitive trials or theoretical explorations.DATA SYNTHESIS: The 9 trials included druginterventions by using bisphosphonatesin, hormone replacement therapy (HRT), calcium and selective estrogen receptor modulators, and non drug interventions to prevent and treat PMO. Calcium and vitamin D and the derivatives had only weak antiresorptive effects, but they were essential for maintenance of bone strength. HRT could increase bone mineral density (BMD), but it was still not the first choice for prevention of PMO considering its other adverse effects. Alendronate and risedronate were two of the most commo

关 键 词：骨质疏松 绝经后 药物疗法 预防 综述文献 

分 类 号：R681.4[医药卫生—骨科学]