魏戌 章轶立 谢雁鸣

摘要：目前，慢性非传染性疾病（以下简称“慢性病”）已成为严重影响身心健康的公共卫生问题，防治刻不容缓。原发性骨质疏松症是慢性病中的常见病，具有病因复杂、病程长、病情迁延、预后差、常伴有骨折等严重并发症的特点。中医药防治策略主要是辨识中医危险因素，评估发病风险；遵循中西医临床实践指南、重视中药高级别研究证据；开展远期随访研究，采集研究人群中医学信息并建立生物样本库。具体研究方法是在中医“治未病”思想指导下，将临床流行病学调查与试验研究方法有机结合开展疾病防治工作。骨量正常或减少阶段，重点评价中医干预方案改善骨密度情况；骨质疏松尚未发生骨折阶段，重点验证中医、中西医结合干预方案预防骨折的疗效与安全性；骨质疏松性骨折阶段，重点研究中西医结合干预方案是否能够促进骨折愈合和防止骨折再发生，提高生活质量，从而降低致残率和致死率。

关键词：慢性病；原发性骨质疏松症；中医药防治；治未病

DOI：10.3969/j.issn.1005-5304.2018.01.002

中图分类号：R274.915.5 文献标识码：A 文章编号：1005-5304（2018）01-0005-05

Prevention Strategies and Research Methods of TCM for Primary Osteoporosis

WEI Xu1， ZHANG Yi-li2， XIE Yan-ming2

1. Wangjing Hospital， China Academy of Chinese Medical Sciences， Beijing 100102， China；

2. Institute of Basic Research in Clinical Medicine， China Academy of Chinese Medical Sciences， Beijing 100700， China

Abstract： Chronic non-infectious diseases （hereinafter referred to as “chronic disease”） have become a serious public health problem which affect the physical and mental health. Its prevention and control is urgent. Primary osteoporosis is a common chronic disease， which has complex causes， long duration， protracted illness， and poor prognosis， and is often accompanied by fracture and other serious complications. Control strategies of TCM are identify the risk factors of TCM and assess the risk of illness； follow the clinical practice guidelines in Western medicine and TCM and attach great importance to the high-quality evidence of TCM； collect TCM information of study population and established the biobank through long-term follow-up study. The specific method was： according to the TCM theory of “treat pre-disease”， the clinical epidemiological investigation and experimental research methods are combined to carry out disease prevention and control work. In the stage of normal bone mass or osteopenia， the clinical efficacy of TCM program in improving bone mineral density were mainly evaluated. In the stage of osteoporosis （fracture has not yet occurred）， the main object was to verify efficacy and safety of TCM or integrative programs preventing the fracture. In osteoporotic fracture phase， the focus was to evaluate whether the combination therapy programs could promote healing， prevent recurrence of the fracture and improve the quality of life， thus reducing morbidity and mortality.

Keywords： chronic disease； primary osteoporosis； prevention and treatment of TCM； treat pre-disease

近年來，慢性非传染性疾病（以下简称“慢性病”）已成为影响公众健康的主要疾病，也是医疗费用快速

基金项目：国家自然科学基金面上项目（81373885）；国家中医临床研究基地业务建设第二批科研专项（JDZX2015076）；北京市中医药科技发展资金项目（JJ2015-57）

通讯作者：谢雁鸣，E-mail：datamining5288@163.com

增长的重要原因。世界卫生组织于2005年10月26日发表《Preventing Chronic Disease：A Vital Investment》（《预防慢性病：一项至关重要的投资》），提供了广泛的流行病学与经济学数据，指出慢性病危害不同层次收入国家，必须采取行动减缓其影响[1]。……