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从"阳明"探讨原发性骨质疏松症的防治

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原发性骨质疏松症是临床常见年龄相关性骨关节病,属于中医"痿证"范畴.随着研究的不断深入,发现中医药对本病的防治具有很好疗效,成为治疗本病的主要手段之一.众多医家认为本病的发生与"肝肾"关系最为密切,并着手于"肝肾"对本病进行辨治.然《黄帝内经》中明确提出"治痿独取阳明"的学术观点,说明"阳明"与本病的发生发展关系密切,因此深入探讨"阳明"的内涵及其与本病的关系或许能为中医药防治本病提供新依据及思路.文章基于文献研究,对现有研究结果进行分析及总结,探讨从"阳明"的角度防治原发性骨质疏松症的依据及方法,认为"治痿独取阳明"中的"阳明"专指脾胃,并包括脏腑及经络两个方面的功能.脾胃与骨痿之间的关系包含以下几个方面,其一,脾胃虚弱致先天失充,宗筋、肌肉失养是骨痿发病的重要原因;其二,脾胃湿热下流乘肾致肾虚髓枯,或母病及子致肺金湿热、肾水乏源亦会导致骨痿的发生;其三,中焦脾胃是人体气机升降之枢纽,中焦气机失调致气滞血瘀是造成或加重骨痿的重要因素.因此,临证应重视从补虚、清脾胃湿热、调畅中焦气机等方面辨治原发性骨质疏松症,选用针灸疗法时从"阳明"进行选经取穴或能获得满意效果,且通过养生调摄增强脾胃正气可在一定程度上预防本病.
Discussion on the prevention and treatment of primary osteoporosis from Yangming
Primary osteoporosis is a common age related osteoarthritis in clinical practice,belonging to the category of flaccidity syndrome in traditional Chinese medicine.With the continuous deepening of research,it has been found that traditional Chinese medicine has good therapeutic effects in the prevention and treatment of this disease,and has become one of the main methods for treating this disease.Many doctors believe that the occurrence of this disease is most closely related to the liver and kidney,and have started to differentiate and treat this disease based on the liver and kidney.However,the academic viewpoint of treating impotence only from Yangming(阳明)was clearly proposed in Huangdi Neijing(《黄帝内经》),indicating that Yangming is closely related to the occurrence and development of this disease.Therefore,in-depth exploration of the connotation of Yangming and its relationship with this disease may provide new basis and ideas for the prevention and treatment of this disease in traditional Chinese medicine.Based on literature research,this article analyzes and summarizes existing research results,and explores the basis and methods for preventing and treating primary osteoporosis from the perspective of Yangming.It is believed that Yangming in treating impotence from Yangming alone specifically refers to the spleen and stomach,and includes the functions of the organs and meridians.The relationship between the spleen and stomach and bone dysfunction includes the following aspects:firstly,kidney deficiency and muscle dystrophy caused by spleen and stomach weakness are important causes of bone dysfunction.Secondly,dampness and heat in the spleen and stomach can lead to kidney deficiency,or dampness and heat in the lungs and lack of kidney water can also lead to the occurrence of bone dysfunction.Thirdly,the spleen and stomach are the hub for the rise and fall of the human body's Qi(气),and the imbalance of the spleen and stomach Qi function leading to Qi stagnation and blood stasis is an important factor that causes or exacerbates bone dysfunction.Therefore,in clinical practice,attention should be paid to the differentiation and treatment of primary osteoporosis from the aspects of tonifying the deficiency,clearing the damp-heat of the spleen and stomach,regulating the Qi movement of the spleen and stomach,etc..The selection of meridians and acupoints from Yangming of acupuncture and moxibustion therapy may achieve satisfactory results,and strengthening the spleen and stomach through health preservation can prevent this disease to a certain extent.

Primary-osteoporosisBone atrophyYangmingSpleen and stomachPrevention and cure

成荣新、黄小桦、陈鉴冰、肖雅雯、吴霭玲、朱晓峰

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暨南大学中医学院,广东 广州,510632

原发性骨质疏松症 骨痿 阳明 脾胃 防治

国家自然科学基金广东省自然科学基金

819737172022A1515011660

2024

中医临床研究
中华中医药学会

中医临床研究

影响因子:0.839
ISSN:1674-7860
年,卷(期):2024.16(10)
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