摘要
人体运动系统的退变性疾病中,骨质疏松症和椎间盘退变疾病(intervertebral disc degeneration,IDD)较为常见。临床上骨科病例中普遍存在老年椎间盘退变患者合并病灶相邻椎体的骨质疏松症。目前的研究尚未能明确骨质疏松症和椎间盘退变疾病的病理机制之间存在着怎样的联系,也没有公认的能同时对二者产生明确疗效的药物。中医临床上经常将这两种疾病以"肾虚症"、"血瘀症"进行辨证论治,从而运用补肾活血的药物对其进行治疗,在大量的临床病例中取得了很好的疗效。因此,本文将以治疗骨质疏松和椎间盘退变性疾病为目的,从以下四个方面对补肾活血中药的作用机制进行探讨,即补肾活血中药与椎间盘微循环、雌激素变化致骨质疏松症和椎间盘退变、骨质疏松和椎间盘退变病理过程中炎症因子的变化、骨重建及髓核细胞再生,从而得出补肾活血中药通过上述机制可延缓合并有骨质疏松症的椎间盘退变疾病的进展,并证实骨质疏松参与了椎间盘退变的过程。这一结论可佐证中医补肾活血的机制,为这两种退变性疾病的治疗带来新的思路。
Osteoporosis and intervertebral disc degeneration are the most common degenerative diseases of the human movement system.In clinical orthopaedic cases,it’s not difficult to find elderly patients with intervertebral disc degeneration complicated with osteoporosis of the adjacent vertebral body of the lesion.There is neither clear link between the pathological mechanisms of osteoporosis and IDD in current studies,nor any known drug that can provide a clear response to both.In TCM clinical practice,these two diseases are often treated dialectically with"kidney deficiency"and"blood stasis",so as to treat them with kidney-tonifying and blood-activating drugs.In a large number of clinical cases,good curative effects have been achieved.Therefore,this article is willing to discuss how to treat osteoporosis and IDD from the following four aspects:tonifying kidney and activating blood circulation with intervertebral disc microcirculation,estrogen changes lead to osteoporosis and IDD,inflammatory factors in the process of IDD and osteoporosis pathological changes,bone reconstruction and nucleus pulposus cells regeneration.It is concluded that the mechanism of tonifying kidney and activating blood circulation can delay the progression of IDD disease complicated with osteoporosis and confirmed that osteoporosis is involved in the process of intervertebral disc degeneration.This conclusion can prove the mechanism of tonifying kidney and activating blood circulation in TCM,and bring new ideas for the treatment of these two degenerative diseases.
作者
马南廷
姚啸生
王禹
王琦
MA Nan-ting;YAO Xiao-sheng;WANG Yu;WANG Qi(Liaoning University of Traditional Chinese Medicine,Shenyang,Liaoning 110032;Liaoning Hospital of Traditional Chinese Medicine,Shenyang,Liaoning 110032)
出处
《智慧健康》
2021年第10期33-36,共4页
Smart Healthcare
基金
辽宁省教育厅科技基金(编号2100219097),项目名称:基于“制则生化”理论,探讨鹿茸多肽调节自噬,延缓髓核细胞退变的机制研究
关键词
骨质疏松症
椎间盘退变
补肾活血
中药
Osteoporosis
Intervertebral disc degeneration
Bushenhuoxue
Traditional Chinese medicine
