基于“脾主肌肉”理论探讨脾-肌肉-骨骼-骨质疏松性骨折间相关性
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摘要
骨质疏松性骨折(osteoportic fracture,OPF)作为骨质疏松症(osteoporosis,OP)最严重的并发症之一,严重影响中老年患者的健康及生活质量。脾-肌肉通过血液循环、神经系统、线粒体系统等对骨骼形成生长发育乃至退化有重要作用。"脾主肌肉"理论是经典的中医理论,该理论与现代医学研究成果相吻合。脾-肌肉的功能障碍可导致骨量减少、骨强度下降,最终导致OPF的发生。笔者基于"脾主肌肉"理论从脾-肌肉出发探讨脾-肌肉-骨骼-骨质疏松性骨折间的相关性,重视脾-肌肉在OPF发病中的作用,希望为OPF的防治提供理论依据。
Osteoporotic fracture(OPF) is one of the most serious complications of osteoporosis, which seriously affects the health and quality of life of elderly patients. The spleen-muscle plays an important role in the development and degeneration of bone through its influences on blood circulation, nervous system and mitochondrial system. The theory of "spleen governing muscles" is a classical theory of Chinese medicine, which is consistent with the result of modern medical research. The dysfunction of the spleen-muscle can lead to decreased bone mass and decreased bone strength, which ultimately leads to OPF. This article is based on the theory of spleen governing muscles, from the starting point of spleen-muscle to investigate the correlation of spleen-muscles-bones-osteoporosis fracture, emphasizing the effect of spleen-muscle on the pathogenesis of OPF, and hope to provide theoretical basis for the prevention and treatment of OPF.
Osteoporotic fracture(OPF) is one of the most serious complications of osteoporosis, which seriously affects the health and quality of life of elderly patients. The spleen-muscle plays an important role in the development and degeneration of bone through its influences on blood circulation, nervous system and mitochondrial system. The theory of "spleen governing muscles" is a classical theory of Chinese medicine, which is consistent with the result of modern medical research. The dysfunction of the spleen-muscle can lead to decreased bone mass and decreased bone strength, which ultimately leads to OPF. This article is based on the theory of spleen governing muscles, from the starting point of spleen-muscle to investigate the correlation of spleen-muscles-bones-osteoporosis fracture, emphasizing the effect of spleen-muscle on the pathogenesis of OPF, and hope to provide theoretical basis for the prevention and treatment of OPF.
引文
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[14] Vonderwalde I, Kovacs-Litman A. Aerobic exercise promotes hippocampal neurogenesis through skeletal myofibre-derived vascular endothelial growth factor[J]. Journal of Physiology, 2018,596(5):761-763.
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[19] 李双蕾,陈红霞,陈文辉,等.从“骨肉不相亲”理论探讨少肌症与骨质疏松的关系[J].辽宁中医杂志,2017,44(7):1396-1400.
[20] 黄宏兴,吴青,李跃华,等.肌肉、骨骼与骨质疏松专家共识[J].中国骨质疏松杂志,2016,22(10):1221-1229,1236.
[21] Chartier SR, Mitchell SAT, Majuta LA, et al. The changing sensory and sympathetic innervation of the young, adult and aging mouse femur[J]. Neuroscience,2018,387(9):178-190.
[22] Weng J, Wang YH, Li M, et al. GSK3β inhibitor promotes myelination and mitigates muscle atrophy after peripheral nerve injury[J]. Neural Regeneration Research, 2018, 13(2):324-330.
[23] 谢玮鑫,王双磊,李展春.神经肽Y在骨微损伤修复机制中的作用[J].中国骨质疏松杂志,2018,24(3):411-415.
[24] Ferrucci L,Baroni M,Ranchelli A,et al.Interaction between bone and muscle in older persons with mobility limitations[J].Curr Pharm Des,2014,20(19): 3178-3197.
[25] Ormsbee MJ,Prado CM,Ilich JZ,et al.Osteosarcopenic obesity: the role of bone, muscle,and fat on health[J].J Cachexia Sarcopenia Muscle,2014,5(3): 183-192.
[26] 庄文,张明鸣.肌肉减少症的定义和诊断标准[J].肿瘤代谢与营养电子杂志,2014,1(3): 1-4.
[2] 毛智慧,刘晓亭,孙晓婷,等.运用“脾主肌肉四肢”理论治疗老年肌肉衰减综合征思路浅析[J]. 辽宁中医杂志, 2017,44(7):1407-1409.
[3] 戴娜,何兰,胡晶,等.“脾主肌肉”的理论探讨及其临床意义[J].中医杂志, 2018,59(2):95-99.
[4] 蒋林博,宋敏,刘小钰,等.结合力生长因子探讨骨肉不相亲理论与骨质疏松症[J].中国骨质疏松杂志,2018,24(3):385-388,405.
[5] 郑敏麟,阮诗玮.中医藏象实质细胞生物学假说之一“脾”与线粒体[J].中国中医基础医学杂志,2002,8(5): 330.
[6] 胡齐,宋雅芳,孙莹.中医“脾主肌肉”与线粒体生物合成中能量代谢的相关性探讨[J].时珍国医国药,2014,25(4):1018-1020.
[7] 刘友章,刘江凯,弓淑珍,等.中医“脾主肌肉”与骨骼肌舒缩运动中能量代谢关系的探讨[J].江苏中医药,2009,41(4): 5-7.
[8] 杨维益,梁嵘,杨敏,等.健脾理气法对骨骼肌能量代谢影响的研究[J].中国运动医学杂志, 1994, 13(1): 28-31.
[9] 邓洋洋,孙鑫,李佳,等.去卵巢骨质疏松症模型大鼠股骨、肾、下丘脑中 Smurf1 信号转导蛋白的活性变化研究[J].中华中医药杂志,2014,29(2): 574-578.
[10] 钱先,陶润.健脾益肾方治疗骨质疏松模型大鼠的实验研究[J].南京中医药大学学报,2014,30(4): 351-353.
[11] Gerhardt H,Golding M,Fruttiger M,et al.VEGF guides angiogenic sprouting utilizing endothelial tip cell filopodia[J].J Cell Biol,2003,161(6):1163-1177.
[12] Osaki T,Sivathanu V,Kamm RD.Crosstalk between developing vasculature and optogenetically engineered skeletal muscle improves muscle contraction and angiogenesis[J]. Biomaterials,2018,156:65-76.
[13] Huntsman HD, Rendeiro C, Merritt JR, et al. The impact of mechanically stimulated muscle-derived stromal cells on aged skeletal muscle[J]. Experimental Gerontology, 2018,103(3):35-46.
[14] Vonderwalde I, Kovacs-Litman A. Aerobic exercise promotes hippocampal neurogenesis through skeletal myofibre-derived vascular endothelial growth factor[J]. Journal of Physiology, 2018,596(5):761-763.
[15] Pinheiro M, Dobson CA, Perry D, et al. New insights into the biomechanics of Legg-Calv??-Perthes’ disease: The Role of Epiphyseal Skeletal Immaturity in Vascular Obstruction[J]. Bone Joint Res, 2018, 7(2):148-156.
[16] Neto GR, Novaes JS, Salerno VP,et al. Does a resistance exercise session with continuous or intermittent blood flow restriction promote muscle damage and increase oxidative stress?[J]. J Sports Sci,2018,36(1):104-110.
[17] Vand SDWJ, Van Spreeuwel ACC, Boonen KJM, et al. Engineering skeletal muscle tissues from murine myoblast progenitor cells and application of electrical stimulation[J]. Journal of Visualized Experiments, 2013, 73(73):e4267.
[18] 刘景新,吴卫兵,刘晓丹,等.神经肌肉电刺激对慢性阻塞性肺疾病患者骨骼肌的康复研究进展[J].中国康复理论与实践,2018,24(4):410-415.
[19] 李双蕾,陈红霞,陈文辉,等.从“骨肉不相亲”理论探讨少肌症与骨质疏松的关系[J].辽宁中医杂志,2017,44(7):1396-1400.
[20] 黄宏兴,吴青,李跃华,等.肌肉、骨骼与骨质疏松专家共识[J].中国骨质疏松杂志,2016,22(10):1221-1229,1236.
[21] Chartier SR, Mitchell SAT, Majuta LA, et al. The changing sensory and sympathetic innervation of the young, adult and aging mouse femur[J]. Neuroscience,2018,387(9):178-190.
[22] Weng J, Wang YH, Li M, et al. GSK3β inhibitor promotes myelination and mitigates muscle atrophy after peripheral nerve injury[J]. Neural Regeneration Research, 2018, 13(2):324-330.
[23] 谢玮鑫,王双磊,李展春.神经肽Y在骨微损伤修复机制中的作用[J].中国骨质疏松杂志,2018,24(3):411-415.
[24] Ferrucci L,Baroni M,Ranchelli A,et al.Interaction between bone and muscle in older persons with mobility limitations[J].Curr Pharm Des,2014,20(19): 3178-3197.
[25] Ormsbee MJ,Prado CM,Ilich JZ,et al.Osteosarcopenic obesity: the role of bone, muscle,and fat on health[J].J Cachexia Sarcopenia Muscle,2014,5(3): 183-192.
[26] 庄文,张明鸣.肌肉减少症的定义和诊断标准[J].肿瘤代谢与营养电子杂志,2014,1(3): 1-4.