Differentiation and Treatment of Co-morbidity of Osteoporosis and Knee Osteoarthritis based on the Concept of"Wei(痿)and Bi(痹)Unity"
Osteoporosis and knee osteoarthritis often co-occur and are closely related in terms of epidemiology,clinical symptoms,pathogenesis and other aspects.Therefore,it is necessary to manage the co-morbidity and treat the two as a whole.Based on the overall relationship between wei(痿)and bi(痹)in TCM,it is believed that osteopo-rosis and knee osteoarthritis have marrow loss and bone atrophy as the core pathogenesis of co-morbidity,and micro-fractures as the central pathological link.The overall treatment is rooted in boosting kidney,supplementing marrow and strengthening the bones.According to the pathological manifestations of microfractures in the process of co-mor-bidity,and the different deficiency and excess characteristics of wei and bi,it can be divided into three types,"wei emerging with mild bi","wei and bi progressing simultaneously",and"emphasis on both wei and bi",for treatment.In terms of"wei emerging with mild bi",that is the early stage of osteoporosis,the traditional Daoyin(导引)is the main therapy.For"wei and bi progressing simultaneously",it can be divided into three stages further,including the onset stage,remission stage,and recovery stage of knee pain,treated with Taohong Siwu Decoction(桃红四物汤),Bushen Huoxue Formula(补肾活血方)and self-made Bushen Qianggu Formula(补肾强骨方)as the main formula respectively.For"emphasis on both wei and bi",the proven formula,Qianggu Zhitong Formula(强骨),is taken as the main prescription.
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