BACKGROUND:Estrogen, bisphosphonates, and calcitonin have been shown to improve bone density and decrease fracture rate, among which, alendronate sodium is the most commonly used and gains extensive attention. OBJECTIVE:To compare the treatment outcomes of alendronate sodium and hormone replacement therapies for postmenopausal osteoporosis. METHODS:198 cases of postmenopausal osteoporosis were randomly divided into two groups (n=99 per group), and then respectively given the oral administration of alendronate sodium, 70 mg weekly, continuous for 1 year, and the oral treatment of tibolone tablets (hormone replacement therapy group), 2.5 mg/d, for 1 consecutive year. The bone density and sex hormone levels before and after treatment, the incidence of adverse reactions and the levels of bone turnover makers were compared between two groups. Furthermore, visual analogue scale scores were detected. RESULTS AND CONSLUSION:The bone densities of the femoral neck and L1-4 were significantly improved in both groups after treatment (P<0.05). The hormone replacement therapy significantly decreased the serum levels of estradiol and progesterone, and significantly increased the cortisol level (P<0.05). The visual analogue scale scores in the alendronate sodium group were significantly superior to those in the hormone replacement therapy group (P<0.05). Alendronate sodium significantly decreased serum levels of procol agen type I N-terminal peptide and C-terminal cross-linking telopeptide of type I col agen, as wel as significantly increased alkaline phosphatase and osteocalcin compared with the hormone replacement therapy (P<0.05). The incidence of adverse reactions, such as nausea and fatigue, in the hormone replacement therapy group was higher than that in the alendronate sodium group (P<0.05). These results suggest that alendronate sodium and hormone replacement therapies both can markedly improve the bone density and promote osteogenesis;in contrast, alendronate sodium exerts little influence on hormone levels and slight adverse reactions, achieving better treatment outcomes.%背景：研究表明雌激素、双膦酸盐、降钙素等可在一定程度上提高骨密度和降低骨折发生率，其中阿仑膦酸钠作为临床最常用的双膦酸盐类药物得到人们的关注。目的：对比分析阿仑膦酸钠与激素替代疗法治疗绝经后骨质疏松症的疗效。方法：绝经后骨质疏松症患者198例随机平均分为2组，每组99例，阿仑膦酸钠组口服阿仑膦酸钠，每周70 mg，连续1年；激素代替疗法组口服替勃龙片2.5 mg/d，连续1年，比较治疗前后2组的骨密度、性激素水平，并比较2组患者的不良发应发病率及对骨代谢标志物的影响，同时进行疼痛改善评价。结果与结论：①治疗之后2组的股骨颈及L1-4的骨密度均较治疗前有所改善(P<0.05)；②激素代替疗法组治疗后血清雌激素和孕酮浓度均有下降的趋势，皮质醇有升高的趋势(P<0.05)；③目测类比评分阿仑膦酸钠组优于激素代替疗法组(P<0.05)；④阿仑膦酸盐组血清Ⅰ型原骨胶原 N端肽、血清β胶原降解产物治疗后较激素代替疗法组下降明显(P<0.05)、阿仑膦酸钠组血清骨源性碱性磷酸酶和血清骨钙素较激素代替疗法组上升(P<0.05)；⑤激素替代疗法组的恶心、乏力等不良发应发病率高于阿仑膦酸钠组(P<0.05)；⑥结果说明，阿仑膦酸钠与激素替代疗法治疗绝经后骨质疏松症均可有效的提高骨密度，促进骨形成，阿仑膦酸钠对患者激素水平影响较小且不良反应小，其治疗效果更佳。
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