摘要
股骨头坏死(osteonecrosis of femoral head,ONFH)是目前骨科临床诊疗中的常见疑难病,“坏死-修复-塌陷-骨关节炎”是ONFH患者逐步演变的自然病理过程,文章基于《黄帝内经》中“邪之所凑,其气必虚”拟探析邪气、气虚在ONFH病因病机的重要性,ONFH往往具有共同的“气虚”病机,气虚受邪,邪气隐伏,交织渐进引起血瘀络阻等气血络病疾患,因气虚血瘀络阻,以中气损伤为先,最终伤及五脏精气,五脏之伤,穷必及肾,伤及命门元气,晚期出现明显骨及软骨皲裂、塌陷的状况。因此,药酒浊邪隐伏于内,邪凑气虚,气血络病是ONFH的时空病机共线。在活血通络法基础上溯本求源,从气论治,兼顾“气虚”,于匡扶正气的基础上通补兼施,益气活血通络,可以更好地运用中医药为受ONFH疾病困扰的患者提供帮助,以冀为保髋提供新思路。
Osteonecrosis of the femoral head(ONFH)is a common and difficult disease in orthopedic clinical practice currently.“Necrosis-repair-collapse-osteoarthritis”is a natural pathological process that gradually evolves in patients with ONFH.The importance of evil and Qi deficiency in the etiology and pathogenesis of ONFH attempts to be analyzed,based on the fact that“where evil gathers,its Qi must be deficient”in Internal Classic of Huangdi.ONFH has a common pathogenesis of Qi deficiency.The latent evil and Qi deficiency intertwine and gradually cause blood stasis and collateral obstruction.Qi deficiency,blood stasis and collateral obstruction gradually aggravate,damaging the middle Qi firstly,causing injuries to the essence of the five Zang-organs.The damage to the five Zang-organs will inevitably affect kidney and the vitality of the life gate.In the late stage,there were obvious chapped and collapsed bone and cartilage.Therefore,turbid pathogen of medicinal wine hidden inside and the evil coheres with Qi deficiency,resulting in the co-occurrence of temporal and spatial pathological mechanisms of ONFH.Therefore,based on the method of promoting blood circulation and dredging collaterals,the treatment should trace the origin,take into account“Qi deficiency”,and apply both dredging and tonifying methods to replenish Qi,activate blood and dredge collaterals,so that it can better use traditional Chinese medicine to help patients suffering from ONFH and provide new ideas for hip preservation.
作者
魏腾飞
田佳庆
肖方骏
何宪顺
林锟
陆舜
何晓铭
何敏聪
何伟
魏秋实
WEI Tengfei;TIAN Jiaqing;XIAO Fangjun;HE Xianshun;LIN Kun;LU Shun;HE Xiaoming;HE Mincong;HE Wei;WEI Qiushi(Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong,China;Guangdong Research Institute for Orthopedics&Traumatology of Chinese Medicine,Guangzhou 510378,Guangdong,China;National Key Laboratory of TCM Syndromes/Orthopedics,The Third Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510378,Guangdong,China)
出处
《辽宁中医杂志》
CAS
北大核心
2024年第12期1-4,共4页
Liaoning Journal of Traditional Chinese Medicine
基金
国家自然科学基金面上项目(81873327,82274544)
国家自然科学基金青年科学基金项目(82004392)
广州中医药大学“双一流”与高水平大学学科协同创新团队重大项目(2021XK05)
广州中医药大学“双一流”与高水平大学学科协同创新团队培育项目(2021XK41)
广东省中医骨伤研究院开放课题重点项目(GYH202101-01)
广东省中医骨伤研究院开放课题重点项目(GYH202101-04)。
关键词
股骨头坏死
激素
酒精
气虚
中气
元气
络病理论
osteonecrosis of femoral head
glucocorticoid
alcohol
Qi deficiency
middle Qi
vital Qi
collateral disease theory
