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"肾脂"探析

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肾脂与髓均是生理状态下肾所藏的精微物质,均是肾水在相火的温煦作用下化生而成,二者皆与骨的生理、病理密切相关.关于"肾-精-髓-骨"的理论,业内已达成共识:髓空则骨不坚,补肾益髓是治疗退行性骨疾病的基本治法.关于肾脂与骨,已有记载显示:肾脂枯涸会导致骨髓不充,发展成为骨痹等,病机分虚、实,虚性病机主要是元阳亏虚,肾水失温,实性病机主要是内生火邪和燥邪,病因可能与外感火热邪气、过食苦寒之品以及过劳或后天失养导致暗耗阴血有关;其临床表现以腰脊疼痛、挛急等为主.现代医学文献研究显示,肾脂参与骨生理病理的调节可能与髓中的骨髓间充质干细胞诱导的成骨分化有关;且其可能在天癸的影响下对骨髓间充质干细胞产生一定的影响,但其具体作用机制及规律仍需进一步挖掘、探索.
Analysis of the 'kidney fat'
Both kidney fat and marrow are the essence of the kidney in the physiological state,the material basis of which is kidney water,and both are generated by the warming effect of the Xiang Huo,and both of them are closely related to the physiology and pathology of bone.Regarding the theory of 'kidney-essence-marrow-bone',the experts have reached a consensus:if the marrow is empty,the bone will not be firm,and tonifying the kidney and benefiting the marrow is the basic treatment for degenerative bone diseases.About kidney fat and bone,it has been recorded that:kidney fat drying will lead to bone marrow insufficiency,development of bone bi,etc.,and the pathogenesis can be divided into deficiency and excess.The deficiency mechanism is mainly due to the deficiency of yuanyang and the loss of warmth of kidney water,while the excess one is internal fire and dryness.The etiology of the disease may be related to external pathogenic fire-heat,excessive consumption of bitter and cold products,overexertion or loss of nourishment that leads to latent depletion of yin-blood,its clinical manifestations are mainly lumbar pain,clonus and so on.Modern literature research shows that kidney fat involved in the regulation of bone physiology and pathology may be related to the bone marrow mesenchymal stem cells in the marrow of the bone induced osteogenic differentiation,and it may be under the influence of tiangui,but its specific mechanism of action and the law still need to be further excavated and explored.

Kidney fatKidney essenceMarrowKidney governing boneBone bi

张元俊、周广文、吴永贵、向楠、王正阳、李浩然、王永志、徐锐

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湖北中医药大学,武汉 430060

肾脂 肾精 肾主骨 骨痹

国家自然科学基金面上项目湖北中医名师向楠工作室国家中医药管理局第七批全国老中医药专家学术经验继承工作项目

82074416鄂卫生计生通报[2018]15号国中医药办人教函[2022]76号

2024

中华中医药杂志
中华中医药学会

中华中医药杂志

CSTPCD北大核心
影响因子:1.135
ISSN:1673-1727
年,卷(期):2024.39(9)