老年骨质疏松症治疗药物的特点  

Different drugs for the treatment of senile osteoporosis

作　　者：胡春明[1] 孙大辉[1] 张伟[1] 林崇明[1] 莫丽娟[1] 

机构地区：[1]吉林大学第一医院骨科,吉林省长春市130021

出　　处：《中国组织工程研究与临床康复》2008年第15期2979-2982,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：学术背景:老年骨质疏松症药物治疗大多能使患者骨质量、构型和强度增加,还可使已发生骨折的患者减轻疼痛,防止其功能丧失。目前,临床上治疗骨质疏松的药物主要有抑制骨吸收和促进骨形成两类。目的:总结老年骨质疏松症药物治疗的研究进展。检索策略:应用计算机检索Pubmed数据库1995-01/2007-12的相关文章,检索词"Osteoporosis,Estrogens,Alendronate,Ipriflavone,Parathormone"限定语言种类为English,同时检索中国期刊网,万方数据库1995-01/2007-12相关文章,检索词"骨质疏松,雌激素,阿仑膦酸盐,依普黄酮,甲状旁腺激素",限定语言种类为中文。共检索到56篇文章,对资料进行初审,纳入标准:①与老年骨质疏松症的药物治疗密切相关。②同一领域选择近期发表在权威杂志上的文章。排除标准:重复性研究。文献评价:文献的来源主要是药物治疗老年骨质疏松症方面的随机对照实验。所选用的56篇文献中6篇为综述,其余均为临床或基础实验研究。资料综合:①抑制骨吸收药物:包括雌激素替代疗法、二膦酸盐、维生素D及其代谢产物、异黄酮衍生物和降钙素,主要通过抑制骨转换,减少破骨细胞数量和抑制其活性;抑制骨吸收;降低髋部和其他非椎骨骨折的发生率等发挥作用。②促进骨形成药物:包括氟化物、甲状旁腺激素和他汀类药物,通过促进微骨折愈合,形成新骨小梁,强化骨结构,刺激成骨细胞及骨小梁的增长,促进新骨形成,增加骨密度等发挥作用。③其他药物:包括雄性激素、钙剂、锶盐等。任何治疗骨质疏松的方法必须同时补钙,单纯补钙是无效的,临床观察已证实,给以雄性激素补充治疗是有效的。另外,选择性的组织蛋白酶K抑制剂可能成为治疗骨质疏松的新药。结论:骨质疏松症治疗常用雌激素作为主要的疗法,辅助其他种类繁多的药物,因此需要全面了解这些药物的功能及BACKGROUND： Drug treatment for osteoporosis in old patients can increase bone mass, structure and density, relieve pain induced by fracture, and prevent incidence of bone fracture. To date, the drugs to treat osteoporosis clinically are major classified into two types： restraint of bone resorption and promotion of bone formation. OBJECTIVE： To summarize the research advances of drug treatment of osteoporosis. RETRIEVAL STRATEGY： A computer-based online search of Pubmed was undertaken to identify the articles published in English between January 1995 and December 2007 with the keywords ＂Osteoporosis, Estrogens, Alendronate, Ipriflavone, Parathormone＂. In addition, we searched Chinese National Knowledge Infrastructure and Wanfang database for Chinese articles dated from January 1995 to December 2007 with the above-mentioned keywords in Chinese. Fifty-six articles were collected, and after the first trial, only those （1）highly correlated with drug treatment for senile osteoporosis, and （2）published in recently or authoritative journals were selected. Repetitive studies were excluded. LITERATURE EVALUATION： Randomized controlled trials about drug treatment for senile osteoporosis were included. Of the 56 articles, 6 were review articles, and the others were clinical or basic experimental studies. DATA SYNTHESIS： （1）Drugs that restrain bone resorption include estrogen replacement therapy, bisphosphonates, Vitamin D and its metabolic products, isoflavone derivative and calcitionin. The mechanism is to inhibit bone transformation, reduce osteoclast number and activity, suppress bone resorption, and decrease incidence rate of hip and other non-vertebral fractures. （2）Drugs that promote bone formation include fluoride, parathormone, and statins. The mechanism is to accelerate micro-fracture healing, form new bone trabecula, strengthen bone structure, stimulate osteoblast and trabecular growth, promote new-bone formation, and increase bone density. （3）There are some other drugs that can

关 键 词：骨质疏松 雌激素 异黄酮类 甲状旁腺素 组织构建 

分 类 号：R681.4[医药卫生—骨科学]