首页|基于"成骨-成血管耦联"理论探讨中医药防治激素性股骨头坏死的科学内涵

基于"成骨-成血管耦联"理论探讨中医药防治激素性股骨头坏死的科学内涵

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激素性股骨头坏死(steroid-induced necrosis of the femoral head,SNOFH)是骨科常见难治性疾病,又被视为"不死癌症",若不及时干预将导致患者面临人工全髋关节置换术的风险.近些年研究证实,"成骨-成血管耦联"途径研究SNOFH发生发展的机制具有重要意义.SNOFH中医病机责之于脾肾亏虚为本,瘀血为病,痰阻为渐,毒聚为损."成骨-成血管耦联"机制与"瘀去-新生-骨合"中医理论存在高度契合性.越来越多的临床证据表明中医药治疗SNOFH不仅具有疗效显著、不良反应小、价格低廉等优势,还能提高患者生存质量,为促进股骨头血管重建与再生以及股骨头坏死骨修复等发挥重要作用.基于"瘀去-新生-骨合"理论,临床上多采用补肾活血类中药及中药复方用于SNOFH防治,运用"成骨"之健脾补肾药,"成血管"之活血化瘀药,祛除"抑制因素"之化痰药、祛湿药,有步骤、有层次的治疗SNOFH取得显著效果.因此,从"成骨-成血管耦联"角度探讨SNOFH中医药干预的科学内涵已成为当今研究新热点,能够为后续SNOFH的防治研究和新药研发提供理论参考和借鉴.
Discussion on Scientific Connotation of Traditional Chinese Medicine in Prevention and Treatment of Steroid-Induced Necrosis of Femoral Head Based on Theory of"Osteogenic Angiogenic Coupling"
Steroid-induced necrosis of the femoral head(SNOFH)is a common and refractory disease in orthopedics,and is also regarded as an"immortal cancer".If not intervened in time,the patients will face the risk of total hip arthroplasty.Recent studies have confirmed that the"osteogenic angiogenic coupling"pathway is of great significance to study the mechanism of the occurrence and development of SNOFH.The traditional Chinese medicine pathogenesis of SNOFH takes spleen and kidney defi-ciency as the root,blood stasis as the disease cause,phlegm obstruction as the development and toxin accumulation as the dam-age.The mechanism of"osteogenic angiogenic coupling"is highly consistent with the traditional Chinese medicine theory of"stasis blood removing-new blood regeneration-new bone growth".More and more clinical evidence shows that the treatment of SNOFH with traditional Chinese medicine not only has the advantages of significant curative effect,small toxic and side effects and low price,but also plays an important role in improving the quality of life of patients,promoting the reconstruction and regen-eration of femoral head blood vessels and the repair of osteonecrosis of femoral head.Based on the theory of"stasis blood remo-ving-new blood regeneration-new bone growth",Chinese herbs and prescriptions for nourishing kidney and activating blood are often used clinically for the prevention and treatment of SNOFH.The"osteogenesis"of invigorating spleen and kidney herbs,the"vascularization"of improving blood circulation and dispersing stasis herbs and the"inhibiting factors"of resolving phlegm and removing dampness herbs are used to treat SNOFH step by step and hierarchically and achieve significant results.Therefore,ex-ploring the scientific connotation of traditional Chinese medicine intervention in SNOFH from the perspective of"osteogenic an-giogenic coupling"has become a new research hotspot,which can provide theoretical reference and reference for the follow-up research on prevention and treatment of SNOFH and new drug development.

steroid-induced necrosis of femoral headosteogenic angiogenic couplingstasis blood removing-new blood re-generation-new bone growthtraditional Chinese medicinescientific connotation

郭雪峰、于睿、任艳玲、张成亮、常鸣

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辽宁中医药大学,辽宁沈阳 110847

沈阳市骨科医院,辽宁沈阳 110044

激素性股骨头坏死 成骨-成血管耦联 瘀去-新生-骨合 中医药 科学内涵

国家自然科学基金项目辽宁省教育厅科学研究经费项目

82174260L202043

2024

10.13193/j.issn.1673-7717.2024.07.013

中华中医药学刊
中华中医药学会 ,辽宁中医药大学

中华中医药学刊

CSTPCD北大核心
影响因子：1.007
ISSN：1673-7717
年,卷(期)：2024.42(7)