向楠基于络病学说从“痰”论治骨质疏松症经验
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摘要
骨质疏松症引起的骨痛、骨折等并发症严重影响中老年人的健康及生活质量,络病学说理论指出骨络是分布于骨骼中的络脉,起着运行气血、温煦濡养骨组织的作用,向楠教授基于络病学说理论,阐述了络病-痰浊-骨质疏松症之间的关系,指出骨质疏松症病位在骨络,"痰浊"是重要致病因素,"肾精不足、骨络空虚,痰阻络滞、骨失所养"是基本病机,提出从"痰"论治骨质疏松症理论并进行临床探讨和实验研究,提出"补肾化痰通络"治疗骨质疏松症的新治则,以期丰富骨质疏松症中医病因病机学理论,为骨质疏松症的中医治疗方法提供新的理论依据。
Complications such as bone pain and fracture caused by osteoporosis seriously affect the health and quality of life of middle-aged and elderly people. The theory of collateral disease points out that the collaterals are the collaterals distributed in the skeleton and play the role of running qi and blood,warming and moistening bone tissue. Based on the theory of collateral disease,Professor Xiang Nan expounded the relationship between collateral disease,phlegm turbidity and osteoporosis. It is pointed out that osteoporosis is located in bones and collaterals,phlegm turbidity is an important pathogenic factor,and deficiency of kidney essence,emptiness of bones and collaterals and phlegm blocking collaterals are the basic pathogenesis. The theory of treating osteoporosis with phlegm is put forward,and clinical and experimental studies are carried out. In order to enrich the theory of etiology and pathogenesis of osteoporosis in traditional Chinese medicine(TCM) and provide a new theoretical basis for the treatment of osteoporosis in TCM,a new therapeutic principle of"invigorating kidney,resolving phlegm and dredging collaterals"was proposed.
Complications such as bone pain and fracture caused by osteoporosis seriously affect the health and quality of life of middle-aged and elderly people. The theory of collateral disease points out that the collaterals are the collaterals distributed in the skeleton and play the role of running qi and blood,warming and moistening bone tissue. Based on the theory of collateral disease,Professor Xiang Nan expounded the relationship between collateral disease,phlegm turbidity and osteoporosis. It is pointed out that osteoporosis is located in bones and collaterals,phlegm turbidity is an important pathogenic factor,and deficiency of kidney essence,emptiness of bones and collaterals and phlegm blocking collaterals are the basic pathogenesis. The theory of treating osteoporosis with phlegm is put forward,and clinical and experimental studies are carried out. In order to enrich the theory of etiology and pathogenesis of osteoporosis in traditional Chinese medicine(TCM) and provide a new theoretical basis for the treatment of osteoporosis in TCM,a new therapeutic principle of"invigorating kidney,resolving phlegm and dredging collaterals"was proposed.
引文
[1]李恩,薛延,王洪复,等.骨质疏松鉴别诊断与治疗[M].北京:人民卫生出版社,2005:56.
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[15]杨娜,徐军霞.老年性骨质疏松和血管钙化的相关性[J].心血管病学进展,2018,39(4):651-655.
[16]高子任,李跃华.中医血瘀证与骨质疏松症关系的研究[J].中华中医药杂志,2017,32(11):5154-5156.
[17]孙建芝,牛晓亚,韩丽华,等.痰浊证微观辨证指标的实验研究[J].河南中医,1996,16(2):21.
[18]叶勇.高脂血症与痰浊淤血相关性理论基础与研究依据[J].时珍国医国药,2006,17(8):1561-1562.
[19]Kovacs CS,Ralston SH.Presentation and management of osteoporosis presenting in association with pregnancy or lactation[J].Osteoporos Int,2015,26(9):2223-2241.
[20]蔡晓燕,董光富.脂代谢及血清骨钙素水平与骨质疏松症的相关性分析[J].中国骨质疏松杂志,2016,22(6):711-712.
[21]Mundy G,Garrett R,Harris S,et al.Stimulation of bone formation in vitro and in rodents by statins[J].Science,1999,286(5446):1946-1949.
[22]Beresford JN,Bennett JH,Devlin C,et al.Evidence for inverse relationship between the differentione on of adipocytic and osteogenic cells in rat marrow stroma cell culture[J].JCell Sci,1992(102):341.
[23]胡娅,向楠.补肾化痰方对去卵巢大鼠血清脂联素和抗酒石酸酸性磷酸酶5b的影响[J].吉林中医药,2010,30(12):1101-1102.
[24]胡娅,向楠.补肾化痰方对去卵巢大鼠血清TRACP5b和-CTX的影响[J].现代生物医学进展,2011,12(11):2227-2229.
[25]胡娅,唐曦,向楠.补肾化痰方对去卵巢大鼠骨组织TNF-和IL-6的影响[J].中国实验方剂学杂志,2014,20(16):173-176.
[26]周亚娜,向楠,陈辉.补肾化痰法影响骨髓间充质干细胞成骨分化的实验研究[J].中国中医基础医学杂志,2015,21(3):275-277.
[27]周亚娜,陈辉,向楠.补肾化痰法影响骨髓间充质干细胞成脂分化的实验研究[J].时珍国医国药,2015,26(10):2325-2327.
[28]周广文,向楠,周亚娜,等.补肾化痰方对去势骨质疏松大鼠钙沉积的影响[J].中国骨质疏松杂志,2018,24(3):366-370.
[2]Langdahl B,Ferrari S,Dempster DW.Bone modeling and remodeling:potential as therapeutic targets for the treatment of osteoporosis[J].Ther Adv Musculoskelet Dis,2016,8(6):225-235.
[3]Chen P,Li Z,Hu Y.Prevalence of osteoporosis in China:a meta-analysis and systematic review[J].BMC Public Health,2016,6(1):1039.
[4]葛继荣,郑洪新.中医药防治原发性骨质疏松症专家共识(2015)[J].中国骨质疏松杂志,2015,21(9):1023-1028.
[5]Li SQ,Feng EY,Zhang YY,et al.Study of the gene expression profile in the bone tissue with kidney in deficiency syndromes in primary osteoporosis[J].Chin J Osteoporos,2013,19(12):1215-1218.
[6]Liu T,Song M,Gong YL,et al.Correlation between liver disease and osteoporosis[J].Chin J Osteoporos,2016,22(9):1211-1215.
[7]Sun CT,Yang DX.Advances on Exercise Therapy Preventing Primary Osteoporosis[J].Chinese Archives of Traditional Chinese Medicine,2016,34(9):2249-2252.
[8]Sun N,Deng YY,Sun X,et al.Effect of the nourishing kidney and promoting blood circulation compound on VEGF expression in rat osteoporosis model[J].Chin J Osteoporos,2016,22(9):1096-1100.
[9]周亚娜,向楠.从“痰”论治骨质疏松症[J].湖北中医杂志,2013,35(12):36-38.
[10]周广文,向楠,周亚娜,等.基于钙沉积异常探讨原发性骨质疏松症“痰邪”的理论研究[J].中国骨质疏松杂志,2016,22(4):497-500.
[11]吴以岭.络病学[M].北京:中国中医药出版社,2005:20-21,41,50.
[12]刘锡仪,刘浩宇.下丘脑弓状核在骨质疏松发病机制中的作用[J].广东医学院学报,2014,32(6):881-885.
[13]周正,赵长铭,焦凯,等.交感神经系统-肾上腺素能受体对骨改建的调节作用[J].国际口腔医学杂志,2015,42(3):348-351.
[14]中华医学会骨质疏松和骨矿盐疾病分会.原发性骨质疏松症诊疗指南(2017)[J].中华骨质疏松和骨矿盐疾病杂志2017,5(10):413-444.
[15]杨娜,徐军霞.老年性骨质疏松和血管钙化的相关性[J].心血管病学进展,2018,39(4):651-655.
[16]高子任,李跃华.中医血瘀证与骨质疏松症关系的研究[J].中华中医药杂志,2017,32(11):5154-5156.
[17]孙建芝,牛晓亚,韩丽华,等.痰浊证微观辨证指标的实验研究[J].河南中医,1996,16(2):21.
[18]叶勇.高脂血症与痰浊淤血相关性理论基础与研究依据[J].时珍国医国药,2006,17(8):1561-1562.
[19]Kovacs CS,Ralston SH.Presentation and management of osteoporosis presenting in association with pregnancy or lactation[J].Osteoporos Int,2015,26(9):2223-2241.
[20]蔡晓燕,董光富.脂代谢及血清骨钙素水平与骨质疏松症的相关性分析[J].中国骨质疏松杂志,2016,22(6):711-712.
[21]Mundy G,Garrett R,Harris S,et al.Stimulation of bone formation in vitro and in rodents by statins[J].Science,1999,286(5446):1946-1949.
[22]Beresford JN,Bennett JH,Devlin C,et al.Evidence for inverse relationship between the differentione on of adipocytic and osteogenic cells in rat marrow stroma cell culture[J].JCell Sci,1992(102):341.
[23]胡娅,向楠.补肾化痰方对去卵巢大鼠血清脂联素和抗酒石酸酸性磷酸酶5b的影响[J].吉林中医药,2010,30(12):1101-1102.
[24]胡娅,向楠.补肾化痰方对去卵巢大鼠血清TRACP5b和-CTX的影响[J].现代生物医学进展,2011,12(11):2227-2229.
[25]胡娅,唐曦,向楠.补肾化痰方对去卵巢大鼠骨组织TNF-和IL-6的影响[J].中国实验方剂学杂志,2014,20(16):173-176.
[26]周亚娜,向楠,陈辉.补肾化痰法影响骨髓间充质干细胞成骨分化的实验研究[J].中国中医基础医学杂志,2015,21(3):275-277.
[27]周亚娜,陈辉,向楠.补肾化痰法影响骨髓间充质干细胞成脂分化的实验研究[J].时珍国医国药,2015,26(10):2325-2327.
[28]周广文,向楠,周亚娜,等.补肾化痰方对去势骨质疏松大鼠钙沉积的影响[J].中国骨质疏松杂志,2018,24(3):366-370.