骨质疏松症中西医结合诊疗专家共识(1)

世界中医药2023年4月第18卷第7期·887·专题—筋骨病系列中西医结合诊疗专家共识骨质疏松症中西医结合诊疗专家共识世界中医药学会联合会骨质疏松专业委员会上海中医药大学附属龙华医院中日友好医院教育部筋骨理论与治法重点实验室摘要随着中国老龄化社会的到来，骨质蔬松症(O)成为严重成胁老年人健康的疾病之一。目前该疾病中西医珍疗实践尚存在不足，固此，世界中医药学会联合会骨质蔬松专业委员会组织撰写《骨质蔬松症中西医结合珍疗专家共识》。在充分查阅国内外相关文献和国内外最新研究成采的基础上，结合中国医疗实际情况，针对骨质蔬松的定义、临床珍断、中西医结合治疗、疗效评价、中西医结合预防和康复等方面达成的专家共识。本共识为临床医务工作者在中西医结合临床珍断治疗骨质蔬松症方面提供科学指导，推动中国骨质蔬松症的中西医结合珍疗规范化发展。关键词骨质疏松症：中西医结合；辨证诊疗：专家共识Expert Consensus on the Diagnosis and Treatment of Osteoporosis withIntegrated Traditional Chinese and Western MedicineOsteoporosis Professional Committee of the World Federation of Chinese Medicine Societies,Longhua HospitalShanghai University of Traditional Chinese Medicine,China-Japan Friendship Hospital,Key Laboratoryof Muscle and Bone Theory and Treatment of Ministry of EducationAbstract With the advent of an aging society in China,osteoporosis(OP)has become one of the diseases that seriously threatenthe health of the elderly.Currently,there are still deficiencies in the practice of traditional Chinese and western medicine diagnosisand treatment of OP.Therefore,the Specialized Committee on Bone and Joint Diseases of World Federation of Chinese MedicineSocieties organized the formulation of the"Expert Consensus on the Diagnosis and Treatment of Osteoporosis with Integrated Tra-ditional Chinese and Western Medicine".On the basis of fully consulting relevant literature and the latest research findings inChina and abroad,combined with the actual medical situation in China,the consensus has been formulated on the definition,clini-cal diagnosis,integrated traditional Chinese and western medicine treatment,curative effect evaluation,integrated traditional Chi-nese and western medicine prevention and rehabilitation of OP.This consensus can provide scientific guidance for clinical medicalworkers in the diagnosis and treatment of OP with integrated traditional Chinese and western medicine and promote the standard-ized development of the diagnosis and treatment of OP with integrated traditional Chinese and western medicine in China.Keywords Osteoporosis;Integrated traditional Chinese and western medicine;Diagnosis and treatment based on syndrome dif-ferentiation;Expert consensus中图分类号：R274文献标识码：Adoi:10.3969/isn.1673-7202.2023.07.0011概述按照发病启动因素的不同，OP分为原发性和继随着中国进入老龄化社会，骨质疏松症(0steo-发性两大类型34)。原发性OP又分为绝经后、老年porosis,.OP)的发病率和人数不断攀升，危害越来越性和特发性等类型，前2种OP广泛见于自然衰老人严重，OP带来的经济负担和健康挑战逐渐加大。群。特发性OP主要是指特殊原因诱发或者在患者OP是与年龄密切相关的疾病，年龄增加诱发骨骼质特殊阶段出现的类型。继发性OP是因为某些疾病量下降和脆性骨折频繁发生，导致老年人群的生命或使用药物诱发的0P56,往往有相关疾病的患病质量下降)。OP病理改变是多因素导致的骨密度史和用药史)。目前临床治疗0P均通过2个方面减少、骨强度下降和脆性增强，患者常容易遭受骨的机制：1)抑制破骨细胞的骨吸收：2)增加成骨细胞折，并可影响到全身的代谢性变化)的骨生成。但是由于该病的特殊性，具体到患者用基金项目：国家自然科学基金项目(81930116,81730107,81873321)：国家中医药“传承创新团队”计划项目(ZYYCXTD-C-202202):上海市重中之重研究中心建设项目(202201009)：国家科技部重点领域“创新团队”计划项目(2015RA4002):国家教育部“创新团队”计划项目(RT1270):上海市促进市级医院临床技能与临床创新三年行动计划重大临床研究项目(SHDC2020CR1010A):上海高水平地方高校创新团队计划项目（沪教委人[2022]3号）：上海市长宁区卫生与计划生育委员会光华卓越P1工程(201601,201606)通信作者：阁小萍(1945.08一)，女，本科，主任医师，教授，全国名中医，首都国医名师，研究方向：中西医结合治疗关节炎等风湿免疫疾病的临床研究，E-mail:yanxia