首页|基于"肾气热"探讨绝经后骨质疏松的病机与辨治

基于"肾气热"探讨绝经后骨质疏松的病机与辨治

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绝经后骨质疏松是一种骨代谢疾病,常发生于女性绝经后,属临床难治性疾病。根据绝经后骨质疏松的临床表现,可将其归属于中医学"骨痿""骨枯"等范畴。本文基于"肾气热"理论对绝经后骨质疏松的病因病机进行阐释,提出阴虚津少、阴不涵阳为发病基础,阳亢内热、热薄骨干为中心环节,阴阳互损、骨骼枯槁为终末转归。基于以上病机,发病早期治以滋阴生津、补气养血,方以益阴增液汤加减;中期治以滋阴清热、补肾填精,方以滋阴清热饮加减;终末期治以阴阳并补、固本培元,方以阴阳双补汤加减。同时,探讨"肾气热"与炎症、免疫反应的关联性,以期为临床治疗绝经后骨质疏松提供新思路。
Exploring the pathogenesis and differential treatment of postmenopausal osteoporosis based on the theory of "kidney qi heat"
Postmenopausal osteoporosis (PMO) is a clinically refractory bone metabolic disease that often occurs in women after menopause. According to its clinical manifestations, it is classified as " bone flaccidity" and " bone withering" in traditional Chinese medicine (TCM). Based on the theory of "kidney qi heat", this paper explains the etiology and pathogenesis of PMO. It is proposed that yin deficiency, depletion of liquid, and yin not containing yang form the basis of its pathogenesis. Furthermore, the internal heat of yang hyperactivity and crippled backbones are the central links that lead to the mutual loss of yin and yang and the withering of bones. Based on the above pathogenesis, the early treatment of the disease is based on nourishing yin and promoting liquid, supplementing qi and nourishing blood production using Yiyin Zengye Decoction with modification. In the medium term, the treatment is based on nourishing yin, clearing heat, invigorating the kidney, and supplementing essence using Ziyin Qingre Decoction with modification. In the final terminal stage, the treatment is based on nourishing yin, tonifying yang, and strengthening the foundation using Yinyang Shuangbu Decoction with modification. At the same time, the correlation between "kidney qi heat" and inflammatory and immune reaction is explored to provide new concepts for clinical research and improve the clinical application value of TCM in the prevention and treatment of PMO.

postmenopausal osteoporosiskidney qi heatinflammatory reactionimmune reactionnourishing yin and clearing heat

顾海立、于冬冬

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辽宁中医药大学 沈阳 110847

辽宁中医药大学附属医院

绝经后骨质疏松 肾气热 炎症反应 免疫反应 滋阴清热

国家自然科学基金面上项目

82374480

2024

北京中医药大学学报
北京中医药大学

北京中医药大学学报

CSTPCD北大核心
影响因子:1.568
ISSN:1006-2157
年,卷(期):2024.47(3)
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