摘要
骨质疏松症是当今世界范围内严重危害公众健康,尤其是中老年人的一种常见病、多发病。伴随人口寿命的提高和社会老龄化的进程,骨质疏松症的防治已经引起世界各国医务人员的极大关注。随着社会发展及生物医学模式的转变,人们对健康的认识逐步完善,生存质量作为一种重要的医学评价标准已被广泛应用。国内生存质量的研究近几年刚刚起步。中医学重视患者躯体感觉、生理活动、心理状态和社会活动的综合评估,重视患者生存质量的观察与提高,提高生存质量是中医药临床治疗的一大特色。中医学理论的“整体观念”与生存质量具有相似的内涵,将生存质量纳入中医辨证及疗效评价体系,使之更加客观化、科学化,对于中医药的发展具有重要意义。
本研究在既往的前期研究中,通过临床观察和理论研究,根据“肾主骨”,“脾胃为后天之本”,“不通则痛”等中医理论,总结了原发性骨质疏松症的病因病机、证治规律,提出原发性骨质疏松症以脾肾两虚,胃肠郁滞,气血失和为病机,治疗以通补并用论治骨质疏松症,治以补益脾肾,通腑降浊,调和气血。
临床研究1:课题探讨原发性骨质疏松症患者生存质量及其与中医证型的关系。采用健康状况调查表(SF-36)测查骨质疏松症患者生存质量并与非骨质疏松症受试者对照,同时调查中医证型。结果骨质疏松症患者生存质量各维度的评分显著低于非骨质疏松症。生存质量有的维度受不同的中医证型影响,提示生存质量与中医证型有关。
临床研究2:课题探讨通补并用法对原发性骨质疏松症患者生存质量的影响及临床疗效。采用SF-36量表调查生存质量,并测量腰椎及股骨的骨密度及调查患者的中医症状。经过三个月一疗程治疗后,SF-36量表调查显示,治疗组患者治疗后生存质量各维度评分及总分均有上升,其中躯体角色、机体疼痛、总体健康、社会功能、精力、情感角色、心理健康7个维度及总分的评分变化自身比较具有统计学意义。治疗组与对照组疗后组间比较,治疗组患者在生存质量的躯体功能、躯体角色、机体疼痛、社会功能、精力、心理健康6个维度及总分方面均优于对照组,而在总体健康、情感角色方面未表现出显著性差异。治疗组患者治疗后中医症状积分明显降低,中医证候总有效率优于对照组。治疗组患者股骨骨密度升高有统计学意义。本研究提示了通补并用法治疗原发性骨质疏松具有确切的疗效,并明显改善患者生存质量。
本课题的创新之处在于,探讨生存质量和中医学的关系及生存质量评价在骨质疏松症的应用,认为生存质量能客观的反映中医特色,提出了将生存质量引入骨质疏松症中医疗效评价体系的观点。观察骨质疏松症患者的生存质量及其与中医证型的关系,骨质疏松症患者生存质量显著降低,生存质量有的维度受不同中医证型的影响;从临床观察和生存质量评价探讨了通补并用法对原发性骨质疏松症的影响,通补并用治疗可提高骨质疏松症患者的骨密度,改善症状并能改善生存质量,对于中医治疗骨质疏松症的深入研究及临床评价具有一定意义。
Osteoporosis (OP) is a common disease and frequently occurring among population, especially does harm to aged people’s health. Along with the advance of life expectancy populate of people and aging sociality, the prevention and therapy of osteoporosis has attracted more attention of medical affairs perennials .With the development of social and the transitions of the health view and medical-model , the assessment of quality of life (QOL) in clinical trials has accepted by more and more medical affairs perennials. In our country , the study of QOL is starting. Compared with modern medicine science , traditional Chinese medicine (TCM)pay close attention to the view of person of their health among physical and mental health .TCM see the body as a whole , this opinion is as same as the idea of QOL .Bring the assessment of quality of life into the distinguishability and evaluation of traditional Chinese medicine ,we can make these more objective and scientific .It make important significance for the development of TCM.
Based on the reviewing and summarizing the documents of the concerned theory , in the theoretical research, we explored the etiological , pathogenesis and regularity of diagnosis and treatment .The theory of traditional Chinese medicine revealed“kidney governs the bone”,“spleen is the root of later heaven”and“when there is stoppage ,there is pain”. The study indicated that the basical pathogenesis of POP was spleen-kidney vacuity detriment ,bowl-gastrointestinal depression and stagnation, and disharmony of qi and blood. By using theory of traditional Chinese medicine“tongbu bingyong”, the principles of therapy should be a comprehensive utilization of supplement the spleen and kidney , freeing the bowels and downbear turbidity , harmonie the qi and blood .
Clinical study 1 :The study explored the relationship between the syndrome types differentiated by traditional Chinese medicine and the quality of life (QOL) in patients with osteoporosis (OP). The QOL in patients was investigated with Short Form-36 questionnaire (SF-36) , and compared with that of the non-OP people; the TCM syndrome type was differentiated at the same time by the outcomes of symptoms acquired from the questionnaire. The score of all the domains of QOL was respectively lower in the OP patients than that in the non-OP subjects. The score of some domains of QOL showed correlation with different TCM syndrome types. QOL of OP patients significantly decreased. The variation of syndrome types could significantly influence some domains of QOL.
Clinical study 2 : The study observed the influence of traditional Chinese medicine to the quality of life in the primary osteoporosis (POP) patients . The study wanted to explore the therapeutics effects of traditional Chinese medicine (TCM) and pharmacy on primary osteoporosis (POP) to provide the reference for preventing chronic disease and improving the elder’s quality of life. The QOL in patients was investigated with Short Form-36 questionnaire (SF-36) , 80 patients with POP in community were bone-scanned in lumbar vertebrae and thoghbone to measure the bone mineral density(BMD). They had finished the SF-36 QOL survey questionnaire and TCM syndrome investigation . We randomly selected 40 of them for TCM treated group. The patients were observed for one treatment courses with QOL estimated by Short Form-36 questionnaire ,and referred to the traditional evaluating indexes of clinical efficiency. After three months of treatment,there was significantly difference between the two groups. QOL in the TCM treated group was improved after treatment with the improvement of scores in all domains , while it in domains of role -physical、bodily pain、general health、social functioning、vitality、role emotional and mental health ,there was statistical significance. ( P< 0.05). The score of QOL in six of the eight domains (physical functioning、role-physical、bodily pain、social functioning、vitality and mental health) were higher in the TCM treated group than those in the control group ( P < 0.05) , and no significant difference was shown between the domains of general health and role emotional of the two groups ( P > 0.05).All things we had done suggested that the“tongbu bingyong formula”can improve the bone mineral density and increase the quality of life in the primary osteoporosis (POP) patients. It might be one of the mechanisms for this therapy .It showed that more research into the therapy of TCM and quality of life are needed.
The innovation of this study : The study explored the connotation of life quality and its interrelation with TCM , application of life quality at department of dermatology . The study indicated that the quality of life can objectively reflect the TCM characteristic and put forward the quality of life will be includedin the assessment system of TCM therapeutic effect of OP disease.The study explored the relationship between the syndrome types differentiated by traditional Chinese medicine and the quality of life (QOL) in patients with osteoporosis (OP). The quality of life (QOL) in patients with osteoporosis (OP) was lower than non-OP people . The score of some domains of QOL showed correlation with different TCM syndrome types.The study observed the influence of traditional Chinese medicine to the quality of life in the primary osteoporosis (POP) patients . The study explored the therapeutics effects of traditional Chinese medicine (TCM) the“tongbu bingyong formula”can improve the bone mineral density and increase the quality of life in the primary osteoporosis (POP) patients. They both have very importance sense in the investigation and evaluation of clinic in osteoporosis patient by the traditional Chinese medicine.
引文
[1] 张纾难,韩春生.中医对骨质疏松症的认识沿革与嬗变.中国骨质疏松杂志,1999,(5)1:83～85
[2] 冯世纶.骨质疏松症的中医病名刍议.中国骨质疏松杂志,2001,7(1):91
[3] 李恩.中西医结合研究骨质疏松症的认识及治疗研究概况.现代中医,1998,38:46～48
[4] 赵玉堂,刘凯军,李金花等.骨矿含量与肾虚,肾主骨关系的研究.骨质疏松杂志,1996,2(3):19
[5] 谢雁鸣.老年骨质疏松症研究近况.中医药动态,1994,(1):11
[6] 丁桂芝,李仁康,李榕等.从骨矿含量变化规律看肾主骨理论的科学性.湖北中医杂志,1991,13(2):27
[7] 许志奇,郭素华,杨定焯等.肾虚证骨矿物质含量的初步研究.中西医结合杂志,1991,(4):222
[8] 马斌.老年性骨质疏松症从肾论治的理论基础.中国中医骨伤科杂志,1995,3(2):51～53
[9] 齐振熙.辨证治疗绝经后骨质疏松症.中国中医骨伤科杂志,1998,6(3):28～29
[10] 谢林,姚共和,郭振球.健脾养胃法治疗骨质疏松症初探.湖南中医学院学报,1996,16(4):32
[11] 周丽蓉,俞瑾,孙梅,等.米非司酮治疗子宫肌瘤的临床疗效及机理探讨.上海医学,1998,21(6):316
[12] 李海凤,周伟生.骨质疏松症的中西医病因病机研究进展.现代临床医学生物工程学杂志,2003 ,9 (5) :450～455
[13] 张洪,魏之玉,王景存.补肾疏肝健脾方治疗老年原发性骨质疏松症 38 例.山东中医药大学学报,1997,21(5):375～376
[14] 林求诚.中医衰老指数与中医学年龄的初步分析.中西医结合杂志,1990,10(2):90
[15] 何华.老年气虚血瘀初探.新中医,1991,(7):52
[16] 张继东,陈光强.对衰老机理的认识.山东中医杂志,1992,(6):45
[17] 熊鹏程,蔡斌,黄亮.从“脏虚络痹”论骨质疏松症.中国中医药信息杂志,2005,12(4):90、104
[18] 董滟.培本祛瘀化痰法治疗老年性骨质疏松症.四川中医,2003,21(11):14～16
[19] 励杏娣,翁世芳,刘忠厚等.91 例低骨矿含量者中医辨证初探.中医杂志,1990,(1):45～46
[20] 杨旭,刘征.退化期骨质疏松的中医治疗.实用中医内科杂志,1995,9(2):28
[21] 许书亮,张永宝.骨质疏松症的辨证分型与治疗.中国中医骨伤科杂志,1995,3(4):30～32
[22] 黄平,王会仍.骨质疏松症骨密度测定与中医辨证分型.浙江中西医结合杂志,1999,9(1):21～22
[23] 卿多舜 ,匡高峰,彭明华等.中西医结合治疗骨质疏松的临床研究.中国骨质疏松杂志,1999,9(1):59～61
[24] 罗国良,吴陵.绝经后骨折与骨质疏松 102 例中医治疗.中国骨伤,1996,9(2)33～34
[25] 魏之玉,张洪,朱振铎等.196 例原发性骨质疏松症辨证分析.山东中医学院学报,1996,20(1):30
[26] 王莒生,许昕,金敬善,等.益肾坚骨丸治疗女性骨质疏松症的临床观察.中国骨质疏松杂志,1997,3(4):63
[27] 中国人群骨质疏松诊疗指南(2004 年版).中国骨质疏松杂志,2004,10(s):567～613
[28] 曹亚飞,刘红敏,刘庆思.骨质疏松症的中医证型与治疗原则探讨.中国骨质疏松杂志,2002,8(4):367～369
[29] 刘勇,刘振义等.壮骨补肾法治疗骨质疏松症 54 例.北京中医杂志,1993,(1):28
[30] 梁立,江正玉,刘忠厚等.补肾中药治疗骨质疏松症临床观察.中医杂志,1992,33(11):36～37
[31] 张文泰.骨痿灵治疗中老年骨质疏松症 150 例.中国骨伤.1993,6(6):36
[32] 沈霖,杜靖远,杨家玉等.青娥丸加味治疗老年性骨质疏松症 52 例观察.湖北中医杂志.1994,16(3):16
[33] 沈霖,杜靖远,杨宝玉,等.补肾法防治绝经后妇女骨丢失的研究.中国中西医结合杂志,1994,14(9):515
[34] 张乃钲.强肾增骨宁治疗骨质疏松症的研究.中国中医骨伤科杂志,1995,4(2):15～16
[35] 丁桂枝.补肾健脾胶囊治疗绝经后骨质疏症疗效分析.中国中西医结合杂志,1995,15(7):392
[36] 梁立,王桂业,孟祥禄,等.中药治疗老年性腰背痛临床观察.中国骨质疏松杂志,1998,4(2):55～56
[37] 卞美璐,王莹,袁莉云,等.骨松宝在手术绝经后妇女预防和治疗骨质疏松症的初步观察.中国骨质疏松杂志,1998,4(4):56～59
[38] 王小云,张春玲,莫莉莉,区勇全,韩丽琳.补肾健脾中药对围绝经期妇女骨代谢和雌激素的影响.广州中医药大学学报,2000 ,(17)3:230～232,
[39] 张贵有.二仙坚骨汤治疗老年性脊椎骨质疏松所致腰背部疼痛 65 例报告.中国中医骨伤科杂志,1999,7(2):28～29
[40] 李浩钢.骨密Ⅰ、Ⅱ号方脾肾同补治疗骨质疏松症 32 例.上海中医药杂志.1997;(2):28
[41] 方朝晖,刘健,章小平等.骨疏灵治疗老年性骨质疏松症 60 例临床观察.中国医药学报.1999;14(6):30～32
[42] 施剑杰.壮骨丹防治骨质疏松症的临床研究.河南中医药学刊,1997;12(1):25～26
[43] 蒋淑媛,尚亚平,吴林生等.骨疏康颗粒治疗骨质疏松症的临床观察.中国骨质疏松杂志.1995;1(2):167
[44] 陈继平.虚中夹瘀论治老年性骨质疏松症 38 例.黑龙江中医药.1999;6:29～30
[45] 郑磊.补肝肾强筋骨作用机制的探讨.河南中医.1998;18(4):201～203
[46] 吴征,孙铁.骨愈灵治疗骨质疏松性骨折 32 例临床观察.中国中医骨伤科杂志,1999,7(6):26～27
[47] 施杞,谢可永.补肾填精法防治绝经后骨质疏松症的临床研究.上海中医药杂志,1996,(10):2～7
[48] 程代奇,夏振信,殷新遒.更年平调冲剂治疗骨质疏松症的药理实验和临床初步研究.中国骨质疏松杂志,1999,5(1):71～75
[49] 张洪,魏之玉,王景存.补肾疏肝健脾方治疗老年原发性骨质疏松症 38 例.山东中医药大学学报,1997,21(5):375～376
[50] 盛淦新.健骨丸治疗骨质疏松症 125 例临床观察.中国骨质疏松杂志,1996;2(4):80～81
[51] 于康冉,韩宣印.中医治疗老年骨质疏松症 64 例.四川中医,1995;(4):49
[52] 郭海樱,安行芳,王祉厚.益肾壮骨汤治疗绝经后骨质疏松症 85 例.长春学院学报,1995;11(2):41～42
[53] 张玉生,牛晓播,张志平.中药治疗老年性脊椎骨质疏松所致腰背痛.中医正骨,1997;9(6):28
[54] 黄勇,李万逸.补肾健骨汤治疗老年骨质疏松症临床观察.中医正骨,1998;10(2):38
[55] 张国中.中药治疗痛性骨质疏松症 28 例报告.中国中医骨伤科杂志,1994;2(4):29～30
[56] 黄勇.老年性脊椎骨质疏松并压缩性骨折的诊治附 53 例报告.中国正骨,1993;4(3):13
[57] 李冬冬,李克.手法与中药治疗老年性胸腰椎骨质疏松症 60 例.中国骨伤, 1999 ;(22)2
[58] 刘献祥,吴明霞,吴炳煌,等.针灸对原发性骨质疏松症影响的实验和临床研究.中国骨伤,2000,13(9):519～521
[59] 张乃钲,韩旭华.中西医结合治疗绝经后骨质疏松症的研究.中国中医骨伤科杂志,1995;3(1):14～15
[60] 李隆敏,周樱,邵幸署.丹参酮防治绝经后骨质疏松症.中国骨质疏松杂志,1996;2(1):78～79
[61] 叶安娜.补肾壮骨汤治疗老年性骨质疏松症 60 例临床观察.新中医,1998;30(7):52～53
[62] 萧劲夫,李昂.中医药治疗男性骨质疏松及其股骨颈骨折.中国骨质疏松杂志,1997;3(3):70～73
[63] 高子范,杨言智,马克昌,等.淫羊藿注射液对试管内鸡胚股骨生长的促进作用.中西医结合杂志,1985,(3):72
[64] 刘忠厚,等.骨质疏松症.北京:化学工业出版社,1992,(4):32
[65] 陈坤,于世风,史凤芹.黔岭藿对体外培养的破骨细胞作用研究.中国骨质疏松杂志,1996,2(3):59～61
[66] 李青南,廖进民,吴铁,等.淫羊藿提取液对醋酸泼尼松所致大鼠骨质疏松的骨形态学的影响.中国药学杂志,1996,(8):467～469
[67] 马慧萍,贾正平,白孟海,等.淫羊藿总黄酮对大鼠实验性骨质疏松生化学指标的影响.中国药理学通报,2003 ,19(2) :1871
[68] 李芳芳,宋士军,李建平,等.淫羊藿对成骨细胞增殖分化的影响.中国骨质疏松杂志,1999,5 (2) :701
[69] 蔡曼玲,季晖,刘悦,等.五种淫羊藿黄酮类成分对体外培养成骨细胞的影响.中国药理通讯,2004,21(3) :13
[70] 季晖,刘康,龚晓健,等.淫羊藿总黄酮对摘除卵巢大鼠骨质疏松症的防治作用.中国骨质疏松杂志,2001 ,7(1):4～8
[71] 韩立民,刘波,徐彭.淫羊藿对成骨细胞增殖的血清药理学研究.中医药学刊,2003 ,21(5) :678～680
[72] Chen KM,Ge B F ,Ma H P,et al.The serumof rats administered flavonoid extract from Epimedium sagittatum but not the extract itself enhances the development of rat calvarial osteoblast2like cells in vitro . Pharmazie ,2004 ,59(1):61
[73] 李晶晶,于世凤,李铁军,等.淫羊藿对口腔各矿化组织破骨细胞性骨吸收的体外实验研究.中华口腔医学杂志,2002,37 (5) :391
[74] NuttalM E , Gimble J M. Is there a therapeutic opportunity to eitherprevent or treat osteopenic disorders by inhibiting marrow adipogenesis .Bone ,2000 ,27 :177
[75] 张巧艳,秦路平,黄宝康,等. 蛇床子总香豆素对去卵巢大鼠 OP 的作用. 中国中药杂志,2003 ,28(2) :101
[76] 张巧艳,秦路平,田野苹,等. 蛇床子总香豆素对成骨细胞产生 NO,IL-1 和IL- 6 的影响. 中国中药杂志,2003 ,28(5) :345
[77] Qin L P , ZHang Q Y,Tian Y P , et al . Total coumarins from fruits of Cnidium monnieri inhibit formation and differentiation of multinucleated osteoclasts of rats. Acta Pharmacol Sin ,2003 ,24(2) :181.
[78] 谢华,李青南,黄连芳,等.蛇床子总香豆素对类固醇性骨质疏松的作用.中国药理学报,1994,(4):371
[79] 李朝阳,吴铁,李青南,等.蛇床子素对去卵巢大鼠近侧胫骨代谢影响的定量研究.药理学报,1996,31(5):327 ～332.
[80] 廖进民,等.用骨密度测定来探讨蛇床子总香豆素对激素所致雄性大鼠骨代谢变化的影响.中草药,1997,(6):346
[81] 廖进民,朱青安,卢海俊,等.蛇床子总香豆素对糖皮质激素致大鼠骨质疏松的骨密度和生物力学性能的影响.中国药理学报,1997,18(6):519～521
[82] 张巧艳,秦路平,黄宝唐,等.蛇床子总香豆素对去卵巢大鼠骨质疏松症的作用.中国药理学杂志,2003,38(2):101～103
[83] 张巧艳,秦路平,田野萍,等.蛇床子素对新生大鼠颅盖骨成骨细胞的作用.第二军医大学学报,2000,21(10):935～937
[84] 胡彬, 吴翠环, 陈璐璐.蛇床子素对大鼠成骨细胞中 OPG 和 RANKL 基因 mRNA 表达的影响.中国骨质疏松杂志,2004 ,10(4) :415
[85] 郭昭庆,党耕町,王志国.氟化钠及续断组分对成骨细胞增殖的影响.中国骨科杂志,1998,18(2):84
[86] 王蕊,邱明才.单剂量补肾中药防治去卵巢大鼠骨质疏松的骨形态计量学研究. 天津医药,1999 ,27(3) :131
[87] 卿茂盛,陈小砖,邹志鹏.续断对大鼠骨质疏松性骨折愈合影响的生物力学实验研究.中国医学物理学杂志,2002 ,19(3) :159 ～160
[88] 陈小砖,李福安,曹亚飞.续断对大鼠去卵巢骨质疏松的骨形态计量学研究.中医正骨,2004 ,16(5) :7～9
[89] Jeong J C ,Lee J W, Yoon C H , et al . Stimulative effects of Drynariae Rhizoma extracts on the proliferation and differentiation of osteoblastic MC3T3 - E1 cells.Ethnopharmacol ,2005 ,96(3) :489
[90] Jeong J C ,Lee J W,Yoon C H , et al . Drynariae Rhizoma promotes osteoblast differentiation and mineralization in MC3T3 - E1 cells through regulation of bone morphogenetic protein - 2 ,alkaline phosphatase ,type I collagen and collagenase - 1. Toxicol In Vitro ,2004 ,18(6) :829
[91] 谢雁鸣,许勇钢,赵晋宁,等.骨碎补总黄酮对去卵巢大鼠骨密度和细胞因子IL-6、IL-4、TNF-α水平的影响.中国中医基础医学杂志,2004 ,10 (1) :34～37
[92] 马克昌,等.骨碎补注射液对糖皮质激素引起的大鼠骨质疏松症的影响.中医正骨,1992,4(4):3～4
[93] 马克昌,朱太咏,刘鲜茹,等.骨碎补注射液对培养中鸡胫骨质基钙化的促进作用.中国中药杂志,1995,(3):178
[94] Chang EJ ,Lee WJ ,Cho S H ,et al . Proliferative effects of flavan - 3 - olsand propelargonidins from rhizomes of Drynaria fortunei on MCF - 7 and osteoblastic cells. Arch Pharm Res ,2003 ,26 (8) :620
[95] 王华松,许申明.骨碎补对骨质愈合中 TGF-β1 的影响.中国中医骨伤科杂志,2001,9(4):10～13
[96] 樊粤光,黄永明,曾意荣,等.骨碎补提取液对体外分离破骨细胞性骨吸收的作用. 中国中医骨伤科杂志,2003 ,11(6):4
[97] MiutaH,NishidaH,LinumaM. Effect of crude fractions of Psoralea folia seed extract on bone calcification . Planta Medica,1996,62:150～153
[98] Xiong Z , Wang D , Xu Y,et al . Osteoblastic differentiation bioassay and its application to investigating the activity of fractions and compounds fromPsoralea corylifolia L. Pharmazie,2003,58(12):925
[99] 高昌琨.怀牛膝对维甲酸所致大鼠骨质疏松防治作用的实验研究.基层中药杂志,2001,15(2):9～11
[100] 高晓燕,王大为,李发美,等. 牛膝中牛膝蜕皮甾酮的含量测定及促进骨样细胞增殖活性. 药学学报,2000 ,35(11) :868
[101] 王猛,张新,孙艳涛. 浅谈牛膝的化学成分与功效关系. 山东医药工业,2003 ,22(2) :44
[102] 张立,葛焕琦,赵丽娟. 杜仲叶醇防治糖尿病合并去势大鼠骨质疏松的实验研究. 中国老年学杂志,2003 ,23(6) :370～372
[103] Ha H ,Ho J , Shin S , et al . Effects of Eucommiae cortex on osteoblast -like cell proliferation and osteoclast inhibition. Arch Pharm Res ,2003 ,26(11) :929
[104] 刘忠厚.骨质疏松研究与防治.北京:化学工业出版社,1994,292～297,256～258
[105] 谭晓卫.丹参对骨膜游离移植血管植入影响的实验研究.骨质疏松症.北京:北京化学工业出版社,1992:604
[106] 李隆敏,周樱,邵幸署.丹参酮防治绝经骨质疏松症.中国骨质疏松杂志,1996,(1):78
[107] 崔燎,邹丽宜,刘钰瑜,等.丹参水提物和丹参素促进成骨细胞活性和防治泼尼松所致大鼠骨质疏松.中国药理学通报,2004,20(3):286～290
[108] 谈志龙,邢国胜,于顺禄,等.中药葛根对去卵巢大鼠骨代谢生化指标的影响.中国骨质疏松杂志,2003,9(2):108～110
[109] 郑高利,张信岳,方晓林,等.葛根总异黄酮(TIP)对去卵巢大鼠骨密度和骨强度的影响.中草药,2001,(32)5:422～425
[110] 郑高利,张信岳,孟倩超,等.葛根异黄酮对地塞米松致大鼠骨质疏松症的保护作用.中药材,2002,25(9):643～646
[111] 郑高利,张信岳,金锋,等.葛根异黄酮抑制去卵巢大鼠胫骨骨矿和微量元素丢失.中国现代应用药学杂志,2002,19(4):257～259
[112] 李斌斌,于世凤.葛根素调控骨代谢的体外实验研究.北京大学学报(医学版),2003,35(1):74～77
[113] 黄延玲,石凤英.葛根素对去卵巢大鼠骨密度和骨代谢生化指标的影响.中国临床康复,2004,8(12):2307～2309
[114] 刘晓青,崔燎,吴铁,等.人参水煎剂防治去卵巢大鼠骨量丢失的骨形态计量学观察.中国骨质疏松杂志,2003,9(4):304～307
[115] 谢华,吴先,黄连芳,等.黄芪水提液对大鼠的类固醇性骨质疏松的防治作用.中草药,1997,(1):25
[116] 高子范,马克昌,杨宗智,等.黄芪水提液对培养中鸡胫骨质的促进作用.中草药,1998,(5):18
[117] 李朝阳, 吴铁,黄连芳,等.黄芪水提液与己烯雌酚对去卵巢大鼠骨质疏松的影响.中草药,1998,(1):27
[118] 陈晓超,柯李晶,陈躬瑞,等. 鹿茸粗提液对大鼠成骨肉瘤细胞增殖的调节作用. 中国中药杂志,2004 ,29(1) :74
[119] 郑洪新,任艳玲,杜 松,等.活性鹿茸与热炸茸对去势大鼠骨质疏松症防治作用比较研究.中医药学刊,2004,22(4):616～632
[120] 孙苏亚,王锦,刘铮,等.龟版提取液对去势大鼠骨质疏松的作用.中药药理与临床,1998,14(4):20～22
[121] Yamaguchi K,Shinohara C ,Kojima S ,et al . (2E ,6R) - 8 - hydroxy - 2 ,6 - dimethyl - 2 - octenoic acid ,a novel anti - osteoporotic monoterpene ,isolated from Cistanche salsa . Biosci Biotechnol Biochem, 1999 , 63(4) :731～735
[122] 陈涛.山茱萸水提液对骨质疏松模型小鼠骨形态学影响. 天津药学,2003 ,15(4) :5～32
[123] 邓廉夫.骨质疏松发生的细胞学基础及其防治.实用老年医学,2000,14(3):119～121
[124] 谢林,姚共和,郭振球,等.金刚健骨片对去势雌性大鼠骨质疏松模型骨细胞超微结构的影响 .中医正骨,1999,11(6):8～9
[125] 苏有新,乔水平等.强骨宝 2 号对大鼠激素性骨质疏松的超微结构观察.中国中医骨伤科杂志,2002,10(1):8
[126] 黄岚,冯树芳,王洪复,等.雷公藤多甙对体外培养成骨细胞增殖的影响.上海医科大学学报,2000,27(1):51～53
[127] 徐荣辉,柴本甫,朱雅萍。丹参注射液对鸡胚额骨分离细胞培养生长影响的组织化学观察.中华骨科杂志,1994,14(3):185～187
[128] 丁寅,相马俊一,山本照子,等.丹参对成骨细胞株 MC3T3-E1 细胞碱性磷酸酶活性及 DNA 合成影响的实验研究.华西口腔医学杂志,1996,14(2):104～106
[129] 李浩钢,吴军豪.脾肾同治防治骨质疏松的实验研究.上海中医药杂志,1998,(9):45
[130] 杜靖远,胡光亮,夏志道,等.补肾密骨液对体外培养新生大鼠颅骨成骨细胞增殖的影响.中华实验外科杂志,1998,15(5):465～466
[131] 胡光亮,杜靖远,王洪,等.补肾密骨液对骨代谢影响的体外实验研究。中国骨伤,2000,13(2):83～85
[132] 李朝阳,李青南,吴铁,等.中药补骨二号对去卵巢大鼠骨代谢影响的定量研究.中成药,1994,16(10):32
[133] 张钰聪,陈秉良.骨质疏松与遗传的研究近况.国外医学老年医学杂志分册,2000,21(1):1～4
[134] 刘思金,薛延.骨量的多基因调控.国外医学·老年医学分册,2000,21(4):151～153
[135] 沈霖,杜靖远,赵海波.补肾法对实验性骨质疏松 MMP-9 及Ⅰ型胶原 mRNA 表达的影响.中国中医骨伤科杂志,1998,6(4):1～4
[136] 刘和娣,李恩,佟小旭,等.补肾中药对骨质疏松大鼠基因及表达的影响.中国骨质疏松杂志,1996,2(3):62～64
[137] 刘素彩,张志勇,李恩.补肾中药对骨质疏松大鼠骨基质Ⅰ型胶原表达的影响.中国中医基础医学杂志,2000,6(9):579～581
[138] 刘诗荣,沈霖,等.补肾法对去卵巢大鼠中 TGF-β1 及 Fas 的影响.中国中医骨伤科杂志,2003,11(2):23
[139] 安胜军,李恩,等.雌激素受体多态性与女性绝经后骨质疏松症中医辨证分型关系的研究.中国中西医结合杂志,2000,20(12):907
[140] 冯世纶,夏志道,吴文才.治痹补骨丹治疗绝经后骨质疏松症 47 例临床观察.中国骨质疏松杂志,1997,3(2):59～61
[141] 陈列,李宁,等.中药增骨丸对去卵巢致骨质疏松大鼠腰椎骨量及生物力学的影响.中国中医骨伤科杂志,2002,10(3):7
[142] 王建智,冯坤,等.坚骨颗粒对实验性骨质疏松大鼠骨代谢和骨强度的影响.山东中医杂志,2001,20(3):164.
[143] 谢雁鸣,张文直,李承军,等.补肾生髓胶囊对去势大鼠骨质疏松的影响.中药新药与临床药理,1997,8(4):210～213
[144] 丁桂芝,曾天舒,周勇,等.补肾中药对去势大鼠骨生物力学影响的研究.中国中医骨伤科杂志,1995,3(1):1～3
[145] 谢晶,杜靖远,沈霖.补肾密骨液作用于卵巢切除大鼠的骨组织计量学研究.中国中医骨伤科杂志,1995,3(6):1～3
[146] 沈霖,杜靖远,杨家玉,等.密骨片防治去睾大鼠骨质疏松症的研究.中国中医骨伤科杂志,1997,5(2):4～6
[147] 罗为民,符诗冲,杜宁,等.健脾补肾法治疗绝经后骨质疏松症的计量学研究.中国中医骨伤科杂志,1995,(2):1
[148] 森本熏夫等.骨质疏松症与细胞因子,日本医学介绍,1996,17(2):55～57
[149] 黄艳红,叶雪清.补肾中药片对围绝经期妇女骨质疏松代谢的影响.中国中西医结合杂志,1993,13(9):522～524
[150] 丁桂芝,周勇,李榕,等.补肾法对骨质疏松大鼠骨代谢影响的作用机理探讨.中国中医骨伤科杂志,1995,3(3):1～4
[151]朱飞鹏,王洪复, 高林峰.补肾中药对肾脏1a羟化酶作用的探讨.上海中医药杂志,2003, 31(12):42～44
[152]范红霞,万力生. 去卵巢大鼠性激素和骨钙素的含量变化及补肾中药对其影响.内蒙古中医药,2000,1:43～44
[153]刘小雨,王行宽,等.补骨脂汤对老年性骨质疏松症患者骨密度、血清 IL-6、TNF、IGF-Ⅱ的影响.中医杂志,2002,43(1):40
[154]鞠大宏,吕爱平,等.滋补肾阴方与温补肾阳方对卵巢切除所致骨质疏松大鼠IL-1 和 IL-6 活性的影响.中国中西医结合杂志,2003,23(4):284
[155]沈培芝,陈东煜.补肾方防治地塞米松致雄性大鼠骨质疏松及其生化机制探讨.中国中西医结合杂志,1998,18(5):290
[156]马立正,施玉华,汪丽亚,等.填精补肾中药对老年大鼠下丘脑-垂体-性腺-胸腺轴的形态学研究.中医杂志,1989,8(1):45
[157]刘秀明,王淑云,李锐,等.微量元素对大鼠颅盖骨成骨细胞样细胞体外培养增殖分化的影响.中华骨科杂志,1995,15(3):177～179
[158]陈训华,危剑安,陈燕平,等.肾虚骨痛胶囊对去势大鼠股骨无机元素含量和骨灰重量的影响.中国中西医结合杂志,1998,18(2):101～103
[1] 刘忠厚.主编.骨质疏松学[M].北京:科学出版社,1998,535～544
[2] 吴青,陶国桓,刘晓玲,等.北京市区 1333 人双能X线骨密度测定及骨质疏松症患者情况调查.中国骨质疏松杂志,1995,1(1):76.80
[3] 徐苓,Cummings SR,秦明伟,等.北京老年妇女脊椎骨折的流行病学研究.中国骨质疏松杂志,1995,1(1)81～84
[4] 汪荷,马燕.骨质疏松症的危险因素分析.中国临床康复,2004;8(14):2734
[5] 刘忠厚主编.骨质疏松学.北京:科学出版社,1998,167～195
[6] Mano H, Yuasa T, Kameda Tiyazawa K ,et al. Mammalian mature osteoclasts as estrogen target cells .Biochem Biophys Res Commun ,1996; 233 (3): 637～642
[7] Kameda T ,Mano H ,Yuasa T ,et al. Estrogen inhibits bone resorption by directly inducing apoptosis of the bone resorbing osteoclasts .J Exp Med ,1997;186(4): 489～495
[8] Scane ,et al . Clin Endocrinal,1993,38:15～16
[9] Pedersen I, Kremer M,Judd J ,et al .Androgens regulate bone resorption activity of isolated osteoclasts in vitro . Proc Natl Axad Sci U S A ,1999,96(2):505～510
[10] 郭世绂.原发性骨质疏松的发病机制.中华骨科杂志 1995;15(5):313
[11] Schanla S,H.,Ziegler.R .维生素 D 及其代谢产物在骨质疏松症发病机制与治疗中的意义.德国医学,1995,12(3)157～158
[12] Anthony W.Norman , 王淑萍; 宋新德.维生素 D 与骨质疏松概述. 中国骨质疏松杂志 1999.02.20; 6(1): 4～13
[13] 薛延,贾维维,张海文,等.骨代谢生化指标随年龄变化及其临床意义.创伤骨科学报,1996,25(1):34～38
[14] 邸明芝,庞炜,王治伦.部分细胞因子在原发性骨质疏松症发病机理中的作用.中国骨质疏松杂志,2000;6(2):87～89
[15] 孙磊,宁志杰.骨再建局部调节因子与骨质疏松.国外医学·老年医学分册,1999,20(2):52～56
[16] 王颜刚.白细胞介素 6 在骨质疏松症发病机制中的作用.国外医学*内分泌分册,1994,14(3):147
[17] Kania DM.J Am Geriatr Soc.1995,43(3):236～239
[18] Kimble RB, Kitazama R, Vannice JL .Persistent bone-sparing effect of I nterleukin-1 receptor antagonist:a hypothesis on the role of IL-1 in orariectomy induced bone loss. Calcif Tissue Int,1994,55:260～265
[19] Kanis JA. Osteoporosis .In: Butter W T,ee .The chemistry and biology of mineralized tissue .Birmingham .AL :Ebsco Media Inc,1984,398～407
[20] Jake AE, Tang WL, Mari CH.Cytokine and hormonal stimulation of human osteosarcoma interleukin -Ⅱ production . Endocrinology ,136:489～498
[21] Vlassara H, Brownlee M, Manogue KR,et al. Cachectin/TNF and IL-1 induced by glucose-modified protein : role in normal tissue remodeling . Sciance ,1988,240(4858):1546～1548
[22] Boonen S, Aerssens J, Dequeker J,et al.. Age-associated decline in human femoral neck cortical and trabecular content of insulin-like growth factorⅠ:potential implications for age-related (tape-Ⅱ) osteoporotic fracture occurrence. Calaf Tissue Int .1997;61(3):173～178
[23] Nicolas V, Prewett A, Bettica P,et al.Age-related decreases in insulin-like growth factor-Ⅰand transforming growth factor-beta in femoralcortical bone form both men and women :implications for bone loss with aging.J Clin Endocrinol Metab,1994;78(5):1011～1016
[24] Kurland ES, Rosen CJ, Cosman F, et al.Insulin-like Growth Factor-Ⅰ in Men with Idiopathic Osteoporosis . J Clin Endocriool Metab ,1997;82(9):2799～2805
[25] 涂意辉,杨安礼. 脉冲电磁场对去势大鼠骨组织胰岛素样生长因子-Ⅰ表达的影响.[J]中国临床康复,2003;7(15):2136～2137
[26] Harris SS .Am J Clin Nutr,1994,60:573～578
[27] Geinoz G,Rapn CH, Rizzoli R,et al. Relationship between bone mineral density and dietary intakes in the elderly. Osteoporosis Int, 1993, 3:242～248
[28] Delmi M, R apin CH, Bengoa JM, et al. Dietary supplementation in elderly patients with fractured neck of the femur .Lancet I, 1990,1013～1016
[29] 李恩,闫素云,丽敏,等.原发性骨质疏松发病的相关因素.中国骨质疏松杂志,1997;3(2):2
[30] 曲玉蓉,高月华.运动与女性原发性骨质疏松症.中国骨质疏松杂志,1999,5(2):24～25
[31] Morrison NA,Qi Jc,Tokita A, et al. Prediction of bone density from vitamin D receptor alleles . Nature ,1994,367: 284～287
[32] 闫丽娜,王晓红,张卉,等.VDR 基因型分布及其与骨矿含量的关系.中国骨质疏松杂志,1997,3(2):19～21
[33] Qi Jc,Estrogen receptor genotypes and bone mineral density in women and men.J Bone Miner Res,1994,10:s170
[34] Keen RW,Woodford Richens KL ,Lanchbury JS, et al. Peak bone mass ,early postmenopausal bone loss and polymorphism at the estrogen receptor gene . Osteoporosis Int, 1996,6:102
[35] 黄琪仁,王钦红,张良平,等.绝经后健康妇女雌激素受体基因多态性与骨密度关系的研究.1998,4(2):38～41
[36] 林忆阳,蔡德鸿.骨质疏松若干候选基因的研究进展.中国骨质疏松杂志,2000, 6(3): 88～92
[37] 刘思金,薛延.骨量的多基因调控.国外医学·老年医学分册,2000,21(4):151～153
[38] 龚慧慈,刘海伦.骨密度的遗传学.国外医学内分泌分册,2003,23(2):84～85
[39] Halaas JL, Gajiwala KS , Maffei M, et al . Weight-reducing effects of he plasma protein encode by the obese gene . Sciene ,1995,269:543～546
[40] Laroche M,Pouilles JM,Rbot C,et al .Comparison of the bone mineral content of the lower limbs in men with ischaemic atheroscherotic disease.Clin Rheumato.l994,13(4):611～614
[41] Parhami F,Garfinkel A,Demer L,et al.Role of lipids in osteoporosis.Aterio -sclerosis,Thrombosis,and Vascular Biology.Journal of the American Heart Associstion, 2000,20(11):2346～2348
[42] 杨光钦,区文超,廉洁,等.雌激素替代治疗对妇女冠心病患者糖代谢和脂代谢的影响.中国老年学杂志,2001,1(21):66
[43] 刘波,于世凤.冠状动脉样硬化性心脏病、高脂血症骨质疏松之间的关系.现代口腔医学杂志,2005,19(5): 531～532
[44] Coelho R, et al. Psychosorn Rea,1999,46(1):29～35
[45] 赵刚,蔡定芳.抑郁和骨质疏松症.国外医学精神病学分册.2002,29(2):104～107
[46] 张亚利,苏康,任惠敏,等.北京市某社区 50 岁以上人群骨质疏松的现状调查和影响因素分析.全科医学杂志,2003,5(1):13～16
[47] 许连娥,张中书,施益群,等.老年人血清 PTHRIR 及其意义.放射免疫杂志,1999 ,12 (1):8～11
[48] D’ Ippolito G,Schiller PC,Ricordi C,et al. Age-related osteogenic potential of mesenchymal stromal stem cells from human vertebral bone marrow. J Bone Miner Res1999;14(7):1115-1122
[49] 李平生,彭朝津,钱红,等.住院老年男性 60 例骨密度与雄性激素关系分析. 中国临床康复,2003,7(5):741
[50] Wallach S, Rousseau G, Martin L. Effects of calcitonin on animal and in vitro models of skeletal metaboliam . Bone ,1999;25(5):509～516
[51] Rhodes EC, Martin AD, Tauntn JE, et al . Effects of one year of resistance training on the relation between muscular strength and bone density in elderly women . Br J S ports Med,2000,34(1):18～22
[52] Prkhouse WS , Coupland DC , Li C, et al . IGF-Ⅰ bioavailability is increased by resistance training in older women with low bone mineral density .Mech Ageing Dev, 2000;113(2):75～83
[53] 任芸芸,朱光珍.孕激素对绝经后骨质疏松的防治.国外医学.妇产科学分册. 1994,(2):76
[54] Lindsay R.Hormone replacement therapy for prevention and treatment of osteoporosis .Am J Med,1993,95(Suppl5A):375
[55] 沈婕,张绍芬.结合雌激素对去势雌性大鼠骨量和血脂代谢的影响.上海医科大学学报,2000;27(3):208
[56] Casper RF, Chapdelain A.Estrogen and interrupted progestin :a new concept for menopausal hormone replacement therapy . Am J obstet Gynecol ,1993;168: 1188～1196
[57] 郭影,马秀敏.雌激素加间断孕激素防止绝经后骨质疏松症.国外医学.老年医学分册,2000,21(1):14～16
[58] Hillard TC ,et al .Osteoporosis Int ,1994;4:341～348
[59] 王洪复,孙爱娥,励杏娣,等.益钙宁对老年骨质疏松症骨密度减少的改善作用.老年医学与保健杂志,1995;1(1):30～31
[60] Hirotoshi M,yoshiki N,Satoshi H,et al.Elcatonin treatment of osteoporosis in calcitonin therapy for osteoporosis . beijing china ,1992:22～26
[61] Fleisch H .Bisphosphonates in osteoporosis :an introduction .Osteoporosis Int,1993,3(Suppl 3):S3
[62] 余传林,陈卫民,徐伟,等.国产羟乙磷酸二钠治疗骨质疏松症 180 例临床验证报告.中国骨质疏松杂志.1997,3(2):52～54
[63] 傅明捷,黄萍,王敏健,等.阿仑膦酸钠对老年男性骨质疏松症骨密度的影响.实用老年病学,2002;6(1):36～37
[64] 郑承志,李洪洋,付乙,等.骨膦抗去势雌鼠骨质疏松研究.中国骨质疏松杂志.1997,3(1):22～26
[65] Riggs BL ,O’Fallon WM, Lane A,et al .Clinical trial of fluoride therapy in postmenopausal ostesporotic women : extended observations and additional analysis .J Bone Miner Res ,1994,9:265
[66] Recker RR .Prevrntion of osteoporosis :calcium nutrition . Osteoporosis Int ,1993,3(Suppl 1):163
[67] Meyer HE ,Smedshaug GB , Kvaavik E ,et al. Can Vitamin D supplement reduce the risk of fracture in the elderly? A randomized controlled trial.J Bone Miner Res,2002;17(4):709～715
[68] Cooper L, Clifton-Blight PB ,Nery ML ,et al .Vitamin D supplementation and bone mineral density in early postmenopausal women .Am J Clin Nutr, 2003;77 (5):1324-1329
[69] 陈一心,韩祖斌,林华.钙补充剂与原发性骨质疏松症. 中国骨质疏松杂志,1996 ,2(1):67～69
[70] 刘忠厚主编.骨质疏松研究与防治,北京;化学工业出版社,1992:372～375
[71] Lips P, Wiersinga A, Van G inkel FC, et al. The effect of vitamin D supplementation on vitamin D status and parathyroid function in elderly subjects. J Clin Endocrinol Metab, 1998,67:644～650
[72] Chapuy M C,Arlot M E ,Duboeuf F, et al. Vitamin D3 and calcium to prevent hip fractures in the eldly women. N Engl J .Med ,1992 ,327(23):1637～1642
[73] Fujita T.Studies of osteoporosis in Japan .Metabolism :Clinical & Experimental ,1990,39:38～42
[74] Neer RM, Arnaud CD, Zanchetta JR, et al .Effect of parathyroid hormone(1-34) on fractures and bone mineral density in posmenopausal women with osteoporosis .New Engl J Med,2001,344(9):1434～1441.
[75] 庄黎.雷洛昔芬获欧盟许可用于预防骨折.国外医药-合成药生化药·制剂分册,1999,20(2):119
[76] 白洁.他汀类药物与骨质疏松症.国外医学内分泌学分册,2002,22(4):217～219
[77] TikizC, UnluZ ,TikizH,etal. The effect of simvas on serum cytokine levels and bone metabolism in postmenopausal subjects :negative correlation betweenTNF- a and anabolic bone parameters . J Bone Miner Metab, 2004,22(4):365～371.
[78] Montagnan A, Gonnelli S ,Cepollaro C , et al..Effect of simvastatin treatment on bone mineral density and bone turnover in hypercholesterolemic postmenopausal women : a 1-year longitudinal study . Bone ,2003, 32(4):427 ～433.
[79] Solomon DH, Finkelstein JS , Wang PS ,et al . Statinlipid- lowering drugs and bone mineral density .Pharmacoepidemiol Drug Saf, 2004, 20;(3):454～458 demiolDrugSaf,2004,[Epubaheadofprint].
[80] Schoofs MW, Sturkenboom MC , van der KliftM ,et al.HMG-CoA reductase in hibitors and the risk of vertebralf fracture.J Bone Miner Res, 2004,19(9):1525～1530
[1] WHO.The Development of the WHO Quality of Life Assessment Instrument. Geneva ,WHO,1993.
[2] 方积乾,万崇华,郝元涛.与健康有关的生存质量的研究概况.中国康复医学杂志,2000,15(1):40～41.
[3] Dubos R.The role of health and the quality of life.West J Med,1976,125(1):8
[4] Holmes OW.The Professor at The Breakfast Tables.London :Routledge& Son,1960:44.
[5] Levi L,Anderson L.Psychological Strcss:Population ,Environment,and Qulity of life. New York:Spectrum Publication,Halsted Press,1975.
[6] 李春波,何燕玲.健康状况调查问卷(SF-36)的介绍.国外医学精神病学分册, 200 2,29:116～119.
[7] 江玲.与健康有关的生存质量评定探讨.中国康复理论与实践,2002,8(12):768～746.
[8] 于普林,袁鸿江.老年医学.北京:人民卫生出版社,2002,326～331.
[9] 曾尔亢,梁渊,王红,等.老年人生活质量及其影响因素研究.国外医学社会医学分册,2003,20(2):80～82.
[10] Patterson TL,Shaw W,Semple SJ,et al.Health-related quality of life in old patients with schizophrenia and other psychoses:Relationship samong psychosocial and psychiatric factors.IntJ Geriatr Psychiatry, 1997;12(4): 452～461.
[11] Covinsky KE , Wu AW, Landefeld CS,et al. Health status versus quality of life in older patients:Does the distinction matter?Am J Med,1999; 106(4): 435～440.
[12] 陈琪尔.提高老年人的生活质量是实现“健康老龄化”的根本保证.中国初级卫生保健,2000;14(5):47.
[13] 于普林,杨超元,何慧德.老年人生活质量调查内容及评价标准建议(草案).中华老年医学杂志,1996;15(5):320.
[14] Baxter J,Shetterly SM. Socialnet work factors associated with perceived quality of life .The SanLuis Valley Health and Aging Study.J Aging Health, 1998;10(3):287～310.
[15] Andresen EM,Pothenberg BM,Panzer R,et al.Selecting age neric measure of health-related quality of life for use among older adults. Acomparison ofcandidate instruments. Eval Health Prof,1998;21(2):244～264.
[16] Struttmann T,Fabro M,Romieu G,et al.Quality of life assessment in the old using the WHOQOL100:Differences between patients with seniledementia and patients with cancer. Int Psychogeriatr,1999;11(3):273～279.
[17] Nagatomo I, Kita K,Takigawa M,et al. A study of the quality of life in elderly people using psychological testing. Int J Geriatr Psychiatry, 1997; 12 (6):599～608.
[18] Iglesias CP,Birks YF, Torgerson DJ.Improving the measurement of quality of life in older people:The YorkSF-12. QJM,2001;94(12):695～698.
[19] Yohannes AM, Roomi J,Waters K,et al.Quality of life in elderly patients with COPD: Measurement and predictive factors .Respir Med,1998;92(10):1231～1236.
[20] Holman K,Eriesson K, Winblad B. Quality of life among the elderly.State of mood and loneliness in two selected groups.ScandJ CaringSci,1999 13(2):91～95.
[21] Ren XS,Chang K. Evaluating health status of elderly Chinese in Boston. J Clin Epidemiol,1998,51:429～435.
[22] Ren XS,Amick B,Zhou L, et al .Translation and psychometric evaluation of a Chinese version of the SF-36 health surevy in the United States.J Clin Epidemiol,1998,51:1129～1138.
[23] 李春波,张明园,何燕玲,等.SF-36 在社区老年人群认知功能与生命质量研究上的应用.中华全科医师杂志,2004,3(1):25～27.
[24] Bito S, Fukuhara S. Validation of interviewer administration of the Short Form 36 Health Survey, and comparisons of health-related quality of life between community-dwelling and institutionalized elderlypeople.Nippon Ronen Igakkai Zasshi,1998;35(6):458～463.
[25] Carver DJ , Chapman CA, Thomas VS ,et al. Validity and reliability of the Medical Outcomes Study ShortForm-20 questionaireasameasure of quality of life in elderly people livingathome.Age Ageing,1999;28(2):169～174.
[26] Ounpuu S, Chambers LW, ChanD,et al . Validity of the USBehavioral Risk Factor Surveillance System's health-related quality of life survey to olina group of older Canadians.Chronic Dis Can,2001;22(3-4):93～101.
[27] 吴小南,黄子杰.生存质量量表信度和效度的初步评价.中国校医,1998;12(5):324～328.
[28] 刘红波,姜又红,刘延龄.SF-36 健康调查问卷应用于社区老年人的信度和效度评价.中国行为医学科学,2001;10(3):244～246.
[29] 汪凯,李秉瑜.农村老年人健康相关生命质量的效度评价.中国卫生统计,1998;15 (5):9～13.
[30] 赵晓华.老龄化社会的健康促进对策.中国初级卫生保健,2000;14(4):44～45.
[31] 朱志明,赵国祥,欧琼,等.城市和山区长寿老年人生活质量影响因素比较分析.中国老年学杂志,1995;15(1):12～14.
[32] Mc Ginnis,JM,Williams Russo P and Knickman J.R.The case for more active policy attention to health promotion. Health Affaires, 2002,21(2):78～93.
[33] 田建辉,王琳,施志明.论生存质量与中医疗效评价.上海中医药大学学报,2002,16(4):32～34.
[34] 胡学军,张伯礼,蔡光先.生存质量在中医药领域中的应用与研究进展.天津中医,2002,19 (6):72～73.
[35] 赵利,刘凤斌,梁国辉,等.中华生存质量量表的理论结构模型研制探讨.中国临床康复,2004,8(16):3132～3134.
[36] 谢仁明,王永炎,谢雁鸣.亚健康状态的中医认识及其干预评价.中国中医基础医学杂志.2005.11(1):40～41.
[37] 方积乾.生存质量测定方法及应用.北京.北京医科大学出版社,2000:244～258.
[38] 吴大嵘,郭新峰,赖世隆.生存质量评测及其在中医药疗效评价中的应用.广州中医药大学学报,2002,19(4):256～260.
[39] 成燕萍,郝天军.中药配合免疫法对老年人非小细胞肺癌生存质量的影响.中国航天工业医药,2001 ,3(2) :56.
[40] 邹雨荷,刘雪梅.黄芪注射液配合化疗对晚期非小细胞肺癌患者生存质量的影响.中国中西医结合杂志,2003,23 (10):733～735.
[41] 蔡红兵,闵清芬,宋海珠,等.中药对放疗后副反应及患者生活质量的影响.上海中医药杂志,2003,37(4):16～18.
[42] 李霞.中药改善晚期妇科恶性肿瘤化疗患者生活质量的观察.四川中医,2003,21 (6):52～54.
[43] 刘智勇,沈英森,王奕鸣,等.养胃合剂对癌症患者免疫功能和生存质量影响的临床研究.辽宁中医杂志,2002,29(3): 151～152.
[44] 李佩文.祛痛灵外用膏治疗癌痛 144 例分析.中国中西医结合杂志,1994,14 (10):616.
[45] 蔡忠仁.岩舒对晚期肝癌患者生存质量的影响.黑龙江中医药,1999,6:62.
[46] 陈伟强, 陈富荣.松龄血脉康胶囊配合卡托普利对原发性高血压患者生存质量的影响.中国中西医结合杂志,2001,21(9):660.
[47] 王克贞.活血化瘀法配合有氧运动改善冠心病患者心功能远期疗效观察.中国临床康复,2002,6(5):745.
[48] 张水源.中药制剂血塞通和乐脉颗粒配合运动疗法对冠心病患者心脏功能的影响.中国临床康复,2002,(5):746.
[49] 阮新民,林宇,江巍,等.中医辨证施治改善冠状动脉搭桥患者生活质量的临床观察.中国中西医结合杂志,2003,23(11):804～807.
[50] 张禾,腾颖. 归龙汤治疗恢复期中风 122 例.辽宁中医杂志,1996 ,23(10) :455.
[51] 梁清华,黎杏群,何纲.平肝熄风汤治疗脑溢血患者的生活质量观察.湖南医科大学学报,1996,21(5):403～406.
[52] 胡学军,胡端午.通脉降脂汤治疗脑动脉硬化症的临床观察.山西中医,2001,17(2): 19.
[53] 杨志豪,蔡培勇.中药治疗类风湿性关节炎生活质量评价.陕西中医学院学报, 2001, 24 (11) : 28～29.
[54] 刘金文,冯立科,许少健.金桂外洗方对膝骨关节炎患者生存质量的改善作用.中医药临床杂志,2004,16(1):47～48.
[55] 刘冠贤,范雁飞,叶任高.补气温肾方对血液透析病人生活质量改善的研究.广东医学,1997,18(7):477.
[56] 徐大基,李奋,林启展.健脾补肾中药对维持血液透析患者贫血状况及生存质量的影响.福建中医药,1998,29(1):33.
[57] 杨永铭,刘冠贤,钟伟强.人参养营汤对慢性肾功能衰竭腹膜透析患者生活质量提高的观察.中国中西医结合急救杂志,2002,9(3):148.
[58] 刘晓俊,梁宏宇,李桂明.葛根素注射液治疗早期糖尿病肾病的疗效与生存质量观察现代康复,2001,5(6): 135.
[59] 张水源.中西医结合治疗对糖尿病患者生存质量及临床效果的影响.中国临床康复,2002,6(1):122.
[60] 胡学军.女贞养阴汤合美多巴等治疗震颤麻痹的对照观察.美国中华临床医学杂志,2002,2(3/4):2131.
[61] 周福生,张庆宏,黄志新.顺激合剂治疗胃肠功能性疾病生存质量评价.中国中西医结合消化杂志,2002,10(5): 296～297.
[62] 徐发彬,王震奎.中医药治疗60例萎缩性胃炎临床生存质量观察.福建中医药, 2003,34(6): 11～12.
[63] 杨志波,刘炽,谭金华,等.竹黄颗粒剂Ⅱ号对寻常性银屑病患者生活质量影响的研究.中国皮肤性病学杂志,2004,18(2): 93～94.
[64] 赵辉.生存质量测评在辨证施护疗效评价中的应用探讨.河南中医,2004,24(5):83～84.
[65] 许培昌,黄石玺,刘致顺,等.针灸对 95 例中风患者生活独立能力(FIM)影响 的临床观察.中国针灸,1998,18(8):459～461.
[66] 李建生,余学庆.老年 2 型糖尿病患者生存质量及影响因素分析.中国老年学杂志,2003,23(10):659～661.
[67] Michael R Phillips.西方量表译本的评价和修订.国外医学精神病学分册,1987(3):135.
[1] 方积乾,万崇华,郝元涛.与健康有关的生存质量的研究概况.中国康复医学杂志,2000,15(1):40～41.
[2] 胡学军,张伯礼,蔡光先.生存质量在中医药领域中的应用与研究进展.天津中医,2002,19(6):72～73.
[3] 张纾难,韩春生.中医对骨质疏松症的认识沿革与嬗变.中国骨质疏松杂志,1999;( 5)1:83～85.
[4] 冯世纶.骨质疏松症的中医病名刍议.中国骨质疏松杂志,2001,7(1):91.
[5] 盛增秀,等主编.脏象概说.上海,上海科技出版社,1980:16.
[6] Schanla S. H., Ziegler. R..维生素 D 及其代谢产物在骨质疏松症发病机制与治疗中的意义.德国医学,1995,12(3)157～158.
[7] 王少金.从分子生物学角度探讨肾主骨的实质.吉林中医药,1981;(2):12.
[8] 丁继华,等.中医骨伤科基础.北京;中医古籍出版社,1987:145.
[9] 邹素元,老年病学.北京,人民卫生出版社,1981,第一版:248.
[10] 刘杏琴,刘任宏.延缓衰老五脏宜通机理初探.新中医,1998;30(10):3～5.
[11] 聂天义.叶天士络痛证治探讨.上海中医药杂志,1997,(8):12～13.
[12] 李育南,黄连芳,谢华,等.淫羊藿提取液对去睾丸大鼠骨代谢的影响.中草药,1993;24(12):637～638.
[13] 刘福春,丁光霞,李菊仙.淫羊藿多糖对羟基脲所致“阳虚”动物骨髓细胞DNA 合成率的影响.中国中药杂志,1991;16(10):620～622.
[14] 马慧萍,贾正平,白孟海,等. 淫羊藿总黄酮对大鼠实验性骨质疏松生化学指标的影响.中国药理学通报,2003 ,19(2) :1871.
[15] 谢华,吴铁,黄连芳等.黄芪水提液对大鼠的类固醇性骨质疏松的防治作用.中草药,1997,29(1):25.
[16] 刘忠厚.骨质疏松研究与防治.北京:化学工业出版社,1994,292～297,256～258.
[1] 方积乾.生存质量测定方法及应用.北京:北京医科大学出版社,2000,28,263～268.
[2] 许军,胡敏燕,杨云滨,等.健康测量量表 SF-36.中国行为医学科学,1999,8(2):150～153.
[3] 林果为,沈福民.现代临床流行病学.上海:复旦大学出版社,2000:147～150.
[4] 中国人骨质疏松症建议诊断标准(第二稿).中国骨质疏松杂志.2000,6(1):1～3.
[5] 陈和年,胡孟璇,谢方云,等.鼻咽癌患者生存质量量表(SQOL- NPC) 的测试.第一军医大学学报,1996,16(1):28.
[1] 中国人骨质疏松症建议诊断标准(第二稿).中国骨质疏松杂志,2000,6(1):1-3.
[2] 中药新药治疗骨质疏松症的临床研究指导原则.中药新药临床指导原则(第三辑),1997:149-150.
[3] 许军,胡敏燕,杨云滨,等.健康测量量表 SF-36.中国行为医学科学,1999,8(2):150-153.
[4] 延缓衰老中药的筛选规程和临床观察规范.中西医结合杂志,1986,6(9):682.
[5] 张忠兰,刘建立,袁艺,等.依屈磷酸二钠预防绝经后骨丢失的临床观察.中国骨质疏松杂志,1997,3(3):46-48.
[6] 丁桂枝,张忠兰,周勇,等.补肾健骨胶囊中治疗绝经后骨质疏松症疗效分析.中国中西医结合杂志,1995;15(7):392.
[7] 章凤兰.骨质疏松症与中药治疗.中国骨质疏松杂志,1996(2)2:88-89.
[8] 李春波,何燕玲.健康状况调查问卷(SF-36)的介绍.国外医学精神病学分册,2002,29:116～119.
[9] 胡学军,张伯礼,蔡光先.生存质量在中医药领域中的应用与研究进展.天津中医,2002,19 (6):72～73.