骨質疏鬆症的藥物治療

骨質疏鬆症為骨密度減少及骨組織結構破壞而導致骨骼脆弱及容易骨折之骨骼疾病。骨質疏鬆症好發於停經後婦女及年長者，所引起的骨折最常發生於脊椎、髖骨及遠端橈骨（腕部）等部位。骨折可能引起失能，造成生活品質降低、乃至增加死亡率，因此預防及治療骨質疏鬆實為現今高齡化社會之重要議題。在防治骨質疏鬆症骨折時，大部分非藥物治療可藉由改善個人飲食、運動、生活型態、跌倒預防來達成，雖然很不容易，卻是不可或缺的防治措施，較諸藥物、手術等所耗費的資源也是較少的。治療骨質疏鬆症的藥物，依作用機轉的不同，一般可分為三大類：（1）抗骨流失藥物，包括：雙磷酸鹽類、荷爾蒙、雌激素受體調節劑（SERMs）、抑鈣素、RANKL單株抗體等。（2）促骨生成藥物：如副甲腺素。（3）混合作用型藥物：例如鍶鹽。本篇中將分別論述。

關鍵字

骨質疏鬆症；骨吸收；骨生成

並列摘要

Osteoporosis is a bone disease caused by diminished bone density and deteriorated bone structure that leads to increased risk of fragility fractures. Osteoporosis is most commonly seen in postmenopausal women and elderly people. Osteoporotic fractures, usually occurring in vertebrae, hip joint, and distal radius, may cause disability, reduce quality of life, and even increase mortality. Prevention and treatment of osteoporosis are therefore an important issue for today’s aging society.Osteoporotic fractures can be prevented by several non-pharmacological approaches, including: personal dietary improvement, exercise, lifestyle modification, and fall prevention. Although not easy, non-pharmacological approach is an indispensable part of an effective prevention program and is more cost-saving as compared to medical or surgical treatments.Medications for treating osteoporosis can be categorized into three classes according to their mechanisms:1. Antiresorptive agents such as bisphosphonates, hormones, selective estrogen receptor modulators (SERMs), calcitonin, and RANKL monoclonal antibody.2. Osteogenic agents like parathyroid hormone (PTH).3. Mixed medication like strontium ranelate.All of these medications are discussed in this paper.

並列關鍵字

Osteoporosis ； bone resorption ； bone formation

國際替代計量

骨質疏鬆症的藥物治療

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