摘要
股骨头坏死是各种因素引起股骨头内微血管内皮细胞损伤,导致骨细胞坏死和骨陷窝空虚等一系列病理改变的难治性疾病。前期应用活血通络方可明显降低无症状股骨头坏死的临床症状和影像学进展率。中医理论博大精深,络病理论最早雏形始于《黄帝内经》,秦汉时期形成了独立的研究体系,直到现代才发展完善成用于指导血管病变的络病理论体系。有研究基于络病理论探讨股骨头坏死的病因机制,提出股骨头微循环改变可能与络脉病变有关。前期研究发现血瘀是股骨头坏死重要中医病机,贯穿其整个发病过程,但致瘀的原因尚不清楚,结合《素问》"血气不和,百病乃变化而生"、《伤寒论》"营卫不通,血凝不流"、《黄帝内经》"营卫以气血之体作流通之用"、吴以岭院士提出的"络病学说营卫承制调平"思想与前期对股骨头病理的分析,系统阐述经络与脉络在股骨头坏死发病、病机、辨证与治疗中的指导作用,形成股骨头坏死特有的络病理论体系并论述其在新时代实现中医药现代化的科学价值。
Osteonecrosis of femoral head is a series of refractory diseases caused by various factors, such as injury of microvascular endothelial cells in osteonecrosis of femoral head and void of bone lacunae. The clinical symptoms and imaging progression rate of asymptomatic femoral head necrosis can be significantly reduced by activating blood circulation and collaterals in the early stage. The theory of traditional Chinese medicine is extensive and profound. The earliest prototype of the theory of collateral disease was started from Huangdi Neijing. An independent research system was formed in the Qin and Han dynasties. Based on the theory of collateral disease, the etiology and mechanism of femoral head necrosis have been discussed. The earlier study found that blood stasis is the important pathogenesis of TCM femoral head necrosis, running through the whole process. However, the cause of blood stasis is still unclear. Combined with "blood Qi disharmony causing diseases" in Suwen, "Ying-Wei being blocked and blood coagulation without flowing" in Treatise on febrile diseases, "Ying-Wei using Qi and blood as circulation" in Huangdi Neijing, "Ying-Wei theory of collateral diseases" proposed by academician WU Yiling, and our earlier analysis of the pathology of femoral head, this study systematically expounded the guiding role of meridian and collateral in the pathogenesis, syndrome differentiation and treatment of femoral head necrosis, forming a unique collateral disease theoretical system of femoral head necrosis, and discussed its scientific value of realizing the modernization of traditional Chinese medicine in the new era.
作者
魏秋实
沈莹姗
庄至坤
何伟
WEI Qiushi;SHEN Yingshan;ZHUANG Zhikun;HE Wei(The Third Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine,Guangzhou 510378,Guangdong,China;Guangdong Research Institute for Orthopedics&Traumatology of Traditional Chinese Medicine,Guangzhou 510378,Guangdong,China;Third School of Clinic Medicine,Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong,China;Quanzhou Bonesetting Hospital,Fujian University of Traditional Chinese Medicine,Quanzhou 362000,Fujian,China)
出处
《中华中医药学刊》
CAS
北大核心
2021年第7期1-4,共4页
Chinese Archives of Traditional Chinese Medicine
基金
国家自然科学基金(81873327,81573996)
广东省自然科学基金(2017A030313698)。
关键词
股骨头坏死
络病理论
经络
脉络
中医药现代化
osteonecrosis of femoral head
collateral disease theory
meridian and collateral
modernization of traditional Chinese medicine
