浅析“肝肾阴虚”与绝经后骨质疏松的关系
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摘要
经云:"年四十,而阴气自半",女性骨质疏松的发生多从围绝经期激素水平下降、骨量减少开始,而女性在围绝经期最典型的症状是潮热、潮红、盗汗、心烦、失眠、经量及经期异常等绝经综合征症状,中医辨证上多属肝肾阴虚。骨质疏松的发生在祖国传统医学的认识中多是由于"肾气热"引起,其发生以肾虚为本,与肝脾相关,以痰瘀为病理产物并影响绝经后骨质疏松症的发展。而临床上绝经后骨质疏松症的中医证候在不同年龄段的分布存在一定差异性,绝经时间较短的绝经后骨质疏松症患者肝肾阴虚型比例较高,而绝经时间较长的则是脾肾阳虚型、肾虚血瘀型比例较高。肝肾阴虚可能是绝经后骨质疏松的最初环节,并与其他证型之间存在一定的转化关系。
The Yellow Emperor's Internal Canon of Medicine: "forty years, and Yin qi will be half", the women of osteoporosis from the menopausal transition hormone levels drop, bone loss, and women in the menopausal transition is the most typical symptoms of hot flashes, night sweats, upset, insomnia, by volume, and menstrual abnormalities and other symptoms of menopause syndrome,are liver and kidney Yin deficiency syndrome differentiation of traditional Chinese medicine.The occurrence of osteoporosis is mainly caused by "heat renal meridian " in traditional Chinese medicine, which is based on kidney deficiency and related to liver and spleen,and takes phlegm and blood stasis as pathological products and affects the development of postmenopausal osteoporosis.The distribution of TCM syndromes of postmenopausal osteoporosis in different age groups is different. The proportion of Deficiency Of Liver-yin And Kidney-yin in postmenopausal osteoporosis patients with short duration of menopause is higher, while the proportion of spleen and kidney Yang deficiency and kidney deficiency and blood stasis in postmenopausal osteoporosis patients with long duration of menopause is higher.Yin deficiency of liver and kidney may be the initial link of postmenopausal osteoporosis, and there is a certain transformation relationship between it and other syndromes
The Yellow Emperor's Internal Canon of Medicine: "forty years, and Yin qi will be half", the women of osteoporosis from the menopausal transition hormone levels drop, bone loss, and women in the menopausal transition is the most typical symptoms of hot flashes, night sweats, upset, insomnia, by volume, and menstrual abnormalities and other symptoms of menopause syndrome,are liver and kidney Yin deficiency syndrome differentiation of traditional Chinese medicine.The occurrence of osteoporosis is mainly caused by "heat renal meridian " in traditional Chinese medicine, which is based on kidney deficiency and related to liver and spleen,and takes phlegm and blood stasis as pathological products and affects the development of postmenopausal osteoporosis.The distribution of TCM syndromes of postmenopausal osteoporosis in different age groups is different. The proportion of Deficiency Of Liver-yin And Kidney-yin in postmenopausal osteoporosis patients with short duration of menopause is higher, while the proportion of spleen and kidney Yang deficiency and kidney deficiency and blood stasis in postmenopausal osteoporosis patients with long duration of menopause is higher.Yin deficiency of liver and kidney may be the initial link of postmenopausal osteoporosis, and there is a certain transformation relationship between it and other syndromes
引文
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[20]黄宏兴,柴生颋,黄红,等.骨质疏松症中医证型的聚类分析[J].广州中医药大学学报,2007,24(3):180-183.
[21]刑训颜,高毅,管琳,等.绝经后低骨量女性骨密度变化及中医证型分布规律[J].中国中西医结合影像学杂志,2015,8(13):409-410.
[22]顾颖杰,陈霞波,周开,等.150例绝经后骨质疏松症患者中医体质分布规律[J].北京中医药,2016,36(6):549-552.
[23]夏东胜,郭盛君,郭志强,等.绝经后妇女骨质疏松程度与肾虚证型的关系[J].新中医,2001,33,(9):14-15.
[24]黄宏兴,万雷,邓伟民,等.骨保护素、核因子κB受体活化因子配体与绝经后骨质疏松症中医证型变化的关系[J].中国组织工程研究与临床康复,2007,11(10):960-1962.
[2]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治指南(2011)[J].中华骨质疏松和骨矿盐疾病杂志,2011,4(1):2-17.
[3]吴卓,吴佳聪,万春花.2000例围绝经期妇女绝经综合征及相关因素分析[J].河南预防医学杂志,2016,27(7):485-487.
[4]聂广宁,杨洪艳,刘建,等.绝经综合征肾阴肾阳虚患者症候分布症状特点及生存质量比较研究[J].辽宁中医杂志,2016,43(8):1569-1573.
[5]任婕,王天芳,李力,等.更年期综合征常见中医证候及其症状分布特点的文献分析[J].江苏中医药,2008,40(4):67-70.
[6]吴宏进,张志枫,许家佗,等.绝经综合征中医四诊信息及证候特点分析[J].中华中医药杂志,2018,33(9):3918-3922.
[7]邵敏,庄洪,宋文昭.绝经后骨质疏松症生存质量和中医证型的初步研究[J].中医正骨,2000,12(5):265-266.
[8]魏绍斌,杨家林.绝经后骨质疏松症与肾虚的关系[J].中国老年学杂志,1996,16(6):337-338.
[9]邓琳雯,母苓刘艺.130例绝经后骨质疏松症的中医证型分布规律[J].成都中医药大学学报,2016,39(2):76-78.
[10]许兵,刘慧,金红婷,等.经典骨质疏松症模型大鼠的肾虚证研究[J].中医骨伤,2012,25(9):766-770.
[11]沈建华,罗小民.ER和选择性ER调节剂的研究进展[J].中国药物化学杂志,2005,15(5):313-320.
[12]赵红恩.雌三醇在治疗骨质疏松症中的作用机制研究[J].临床合理用药杂志,2009,2(16):33.
[13]任之强,闫晓霞,晋大祥,等.原发性骨质疏松症血瘀与骨代谢关系研究[J].中华中医药杂志,2015,30(5):1838-1840.
[14]张荣华,朱晓峰.脾肾两虚兼血瘀与原发性骨质疏松关系的探讨[J].四川中医,2003,12(5):11-12.
[15]谢林,郭振球,姚共和.绝经后骨质疏松症中医辨证分析[J].中国医药学报,1999,14(3):35-39.
[16]李瀚旻.“肝肾精血亏虚大鼠”模型的建立[J].中国中医基础医学杂志,2001,7(4):51-54.
[17]李瀚旻,高翔,晏雪生,等.左归丸促进骨髓形成肝细胞的研究[J].世界华人消化杂志,2005,13(24):2818-2822.
[18]李春岭,王德惠,李普宏.骨质疏松症的中医病名辨析[J].云南中医中药杂志,2017,38(7):13-15.
[19]徐祖健,旺付,尹思源,等.绝经后妇女原发性骨质疏松症辨证分型与症候特征的探讨[J].中医正骨,2008,20(11):815-816.
[20]黄宏兴,柴生颋,黄红,等.骨质疏松症中医证型的聚类分析[J].广州中医药大学学报,2007,24(3):180-183.
[21]刑训颜,高毅,管琳,等.绝经后低骨量女性骨密度变化及中医证型分布规律[J].中国中西医结合影像学杂志,2015,8(13):409-410.
[22]顾颖杰,陈霞波,周开,等.150例绝经后骨质疏松症患者中医体质分布规律[J].北京中医药,2016,36(6):549-552.
[23]夏东胜,郭盛君,郭志强,等.绝经后妇女骨质疏松程度与肾虚证型的关系[J].新中医,2001,33,(9):14-15.
[24]黄宏兴,万雷,邓伟民,等.骨保护素、核因子κB受体活化因子配体与绝经后骨质疏松症中医证型变化的关系[J].中国组织工程研究与临床康复,2007,11(10):960-1962.