摘要
骨质疏松性椎体骨折(OVF)是最常见的骨质疏松性骨折类型,肌少症与骨质疏松症是OVF的高危因素。OVF、肌少症与骨质疏松症,可归属于中医学“痿证”“肉痿”“骨蚀”等范畴。骨与肉实为肾脏与脾脏之间关系的演变,脾肾功能正常是骨肉相亲的生理基础。骨骼、肌肉均源于近轴中胚层体细胞,在结构、功能以及生物力学与分子生物学方面均紧密关联。OVF的发生,跌扑闪挫是诱因,肾虚是根本,脾虚是关键,血瘀是主要病理产物,脾肾亏虚兼血瘀是OVF的主要病因病机。OVF的病理改变微观上是线粒体功能障碍导致肌肉蛋白合成不足,宏观上是骨骼肌质量与收缩力下降加重肌少症与骨质疏松症进展。补肾健脾活血治疗OVF符合未病先防、既病防变、瘥后防复的治疗原则。
Osteoporotic vertebral fracture(OVF) is the most common type of osteoporotic fracture, for which sarcopenia and osteoporosis are among the high-risk factors. OVF, sarcopenia and osteoporosis fall into the TCM categories of “flaccidity syndrome(wěi zhèng)”, “fleshy flaccidity(ròu wěi)”, and “bone erosion(gǔ shí)”, respectively. TCM believes that the relationship between bones and muscles is in fact the continuation of that between the kidney and the spleen, which further suggests that the normal functioning of the two viscera is the physiological basis of the bone-muscle harmony. Bones and muscles, both stemming from paraxial mesodermal somatic cells, are closely related with each other in structure, function, biomechanics and molecular biology. In the occurrence of OVF, injuries due to falling, tumbling, spraining, or contusion are the inducement, while kidney deficiency is the root, spleen deficiency is the key, and blood stasis is the main pathological product, indicating that spleen-kidney deficiency and blood stasis are the main causes and pathogenesis of OVF. Microscopically speaking, mitochondrial dysfunction leads to insufficient muscle protein synthesis, which manifests in the decline of skeletal muscle mass and contractility, aggravating sarcopenia and osteoporosis. The treatment of OVF by the method of supplementing the kidney, fortifying the spleen and invigorating blood is in line with the principle of prevention before disease onset, controlling development of existing diseases and keeping the disease from recurring after recovery.
作者
袁林
李亚锋
赵学千
杨浩田
马慧
谭建盛
秦炜明
贾育松
YUAN Lin;LI Yafeng;ZHAO Xueqian;YANG Haotian;MA Hui;TAN Jiansheng;QIN Weiming;JIA Yusong(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700;Yuquan Hospital,Tsinghua University)
出处
《现代中医临床》
2023年第1期72-75,共4页
Modern Chinese Clinical Medicine
基金
北京中医药大学东直门医院科技创新专项课题(No.DZMKJCX-2020-057)。
关键词
骨质疏松性椎体骨折
肌少症
骨质疏松症
骨肉不相亲
补肾健脾活血
osteoporotic vertebral fractures
sarcopenia
osteoporosis
disharmony between bone and muscle
supplementing the kidney
fortifying the spleen and invigorating blood
