|
There is no cure for osteoporosis. Treatment involves the management of acute fractures, modifying risk factors, treating other symptoms of the disease and its sequelae, and maintenance of skeletal mass and integrity. Increasingly, emphasis is placed on the prevention of osteoporosis and on ways of building bone mass before the age of 30 years.
Maintenance of skeletal mass is accomplished by:
 |
oral calcium supplementation ( Calcium carbonate is the most efficient source of calcium and is the least expensive. Because calcium is absorbed better with food, it should be given with meals.). |
|
vitamin D therapy |
|
weight-bearing activity through a daily exercise program |
|
sodium fluoride therapy. |
Treatment of acute symptoms is aimed at relieving pain, providing comfortable mechanical support for the spine, fostering better qualities of daily living, coordinating a rehabilitation program, and providing support, encouragement and reassurance to the patient and family.
Drug treatment of osteoporosis can include the following:
|
Estrogen replacement therapy, or combined hormone replacement therapy, is often prescribed for women at menopause. Hormone replacement therapy has a beneficial effect on the cardiovascular system and on bone structure, but because it increases the risk for breast and gynecologic cancers, careful assessment of these patients is necessary. |
|
Calcitonin, a polypeptide hormone with antiresorptive effects, can be administered in the form of a nasal spray or injection to both men and women for prevention of further bone loss. |
|
Other drugs which have received approval for prevention and/or treatment of osteoporosis (and act by slowing or stopping bone loss, increasing bone density and reducing fracture risk) include the biphosphonates alendronate, etidronate and risedronate, and the selective estrogen receptor modulator raloxifene. Calcium should not be given concurrently with bisphosphonates as it impairs their absorption. |
|
| |
|
|
A blend of Western and TCM approaches can be of benefit in the treatment of osteoporosis. Often a combined treatment produces better outcomes than the exclusive use of one method. It is best to get the advice of a TCM practitioner who knows what is best for you and your condition. The treatments described below are some approaches that may be taken to treat the different TCM syndromes associated with osteoporosis.
| 1. Yin deficiency of liver and kidney |
Therapeutic aim:Nourishes yin for kidney and liver, replenishes jing and marrow.
Prescription: liuwei dihuang pellet with modification
| gan di huang |
dry rehmannia root |
| shan yu rou |
Asiatic cornelian cherry fruit |
| huai shan yao |
common yam root |
| fu ling |
Indian bread |
| dan pi |
tree peony bark |
| gou qi chi |
Barbary wolfberry fruit |
| chuan duan |
Himalayan teasel root |
In this prescription, rehmannia, cornelian cherry and wolfberry are used to nourish the yin of the liver and kidneys; peony bark clears away heat evil and nourishes yin. Common yam and Indian bread invigorate the spleen and eliminate dampness evil; they also counteract the greasy properties of the other herbs. Teasel root tonifies the kidneys and strengthens tendons and bones.
| 2. Blood deficiency and excessive dampness |
Therapeutic aim: Nourishes the blood and dispels dampness evils.
Prescription: Danggui Shaoyao powder plus additional supplement
| dang gui |
Chinese angelica |
| bai shao |
white peony root |
| fu ling |
Indian bread |
| bai zhu |
large head atractylodes root |
| ze xie |
oriental waterplantain rhizome |
| chuan xiong |
Szechuan lovage root |
| fang ji |
four stamen stephania root |
| gui zhi |
cassia twig |
| gan jiang |
dried ginger |
| gan cao |
liquorice root |
In the prescription, angelica, peony root and lovage root are used to activate blood circulation and nourish the blood. Cassia can remove obstruction in the meridians, activate blood circulation, and relieve joint pain. Indian bread, atractylodes root, waterplantain rhizome, and stephania root are used to invigorate the spleen and eliminate dampness evil. Ginger and liquorice root warm the middle burner and ease the stomach. Additionally, angelica, peony root, and lovage root can stimulate blood production. Indian bread, atractylodes root and cassia also eliminate the dampness evil and relax the tendons, as well as nourishing the tendons and bones.
| 3. Retention of dampness due to kidney deficiency |
Therapeutic aim: Warms the yang and dispels dampness evils.
Prescription: zhenwu decoction plus additional supplement
| zhi fu pian |
prepared common monkshood daughter root |
| bai shao |
white peony root |
| sheng jiang |
fresh ginger |
| fu ling |
Indian bread |
| bai zhu |
large head atractylodes root |
| gui zhi |
cassia twig |
| bu gu zhi |
malaytea scurfpea fruit |
| chuan duan |
Himalayan teasel root |
| sang ji sheng |
Chinese taxillus herb |
| xing ling pi |
epimedium herb |
| ji xue teng |
suberect spatholobus stem |
In the prescription, monkshood and epimedium are used to warm the yang or the body. Ginger, Indian bread and atractylodes warm the middle burner (spleen and stomach) and promote the secretion of urine. Peony root, cassia and spatholobus nourish the blood and remove obstruction in all the meridians. Scurfpea, teasel and taxillus nourish the kidney and strengthen the bones, loins, and legs.
Therapeutic aim: Strengthens the middle burner, benefits the qi, harmonizes nutrients and defends qi. It does this by providing a yang energy in the body derived from the digestion and absorption of foods by the spleen and stomach. This helps protect the skin and muscle, provides resistance against the exogenous pathogens and regulates the secretion of sweat.
Prescription:fangyi huangqi decoction with modification
| sheng huang qi |
fresh milkvetch root |
| fang ji |
four-stamen stephania root |
| sheng jiang |
fresh ginger |
| da zao |
Chinese date |
| gan cao |
liquorice root |
| gui zhi |
cassia twig |
| bai shao |
white peony rooti |
| cang zhu |
atractylodes root |
| sheng long ku |
unprocessed fossil fragment |
| sheng mu li |
fresh oyster shell |
In the prescription, cassia, ginger, date, liquorice and milkvetch are used to tonify the stomach, nourish the middle burner, and benefit the qi. Peony root nourishes the qi and regulates the blood circulation. Stephania and atractylodes eliminate dampness evil and relieve joint pain. Fossil and oyster shell arrest premature ejaculation and sweating. The synergistic action of the herbs in this recipe consolidate body resistance, eliminate fluid retention, replenish the kidney and blood, and nourish muscles and bones.
| 5. Cold in the superficies and heat in the interior |
Therapeutic aim: Expels superficial pathogens and clears away heat evil.
Prescription: Yuebi Jiashu decoction with modification
| ma huang |
ephedra |
| cang zhu |
atractylodes root |
| sheng jiang |
fresh ginger |
| da zao |
Chinese date |
| jiu gan cao |
liquorice root |
| shang shi gao |
unprocessed gypsum |
| fang ji |
four-stamen stephania root |
| mu gua |
papaya |
In the prescription, ephedra, ginger, date and liquorice provide pungent and warming properties to warm the middle burner, invigorate the stomach, and relieve the exterior symptoms. Gypsum can clear away interior heat evil. Stephania, papaya, and atractylodes eliminate dampness evil and relieve joint pain.
Therapeutic aim: Nourishes the marrow and smoothes the flow of qi and blood in all meridians.
Prescription: yougui pellet with modification
| shu di huang |
processed rehmannia root |
| shan yao |
common yam root |
| shan zhu yu |
Asiatic cornelian cherry fruit |
| gou qi chi |
Barbary wolfberry fruit |
| jiu gan cao |
liquorice root |
| du zhong |
eucommia bark |
| rou gui |
cassia bark |
| zhi fu zi |
prepared common monkshood daughter root |
| wu she |
black snake |
| xing ling pi |
epimedium herb |
| cang zhu |
atractylodes root |
| gou ji |
cibot rhizome |
| sang ji sheng |
Chinese taxillus herb |
In the prescription, monkshood, rehmannia, cassia, cornelian cherry, eucommia, cibot and epimedium invigorate the kidneys and strengthen the tendons and bones. Atractylodes and taxillus eliminate dampness evil and relieve joint pain. Liquorice helps regulate stomach function and benefits vital qi (energy). |
| |
|
