摘要
在慢性肾脏病(CKD)患者中,骨质疏松症越来越成为隐匿的杀手,影响患者的生活质量和生存率。现代研究认为,成骨细胞-破骨细胞平衡的破坏是骨质疏松症主要的病理原因,免疫功能低下,微血管网络遭破坏及肾脏功能和代谢紊乱亦是其发病的重要因素。中医认为,成骨细胞-破骨细胞的失衡类似于中医的阴阳失衡,“肾主骨生髓”,肾阴精不足,髓海空虚,骨骼失养,日久阴损及阳,导致阴阳两虚,故CKD合并骨质疏松症的根源在于“阳化气”及“阴成形”的功能障碍,在此基础上,又形成瘀血等病理产物。在治疗上,李跃进教授从扶阳法入手,在补助肾阳、益髓填精的基础上,健脾补中以益阳之源,活血化瘀以开阳之路,在临床获效甚佳,望为CKD合并骨质疏松症提供新的治疗思路。
In the patients with chronic kidney disease,osteoporosis has emerged as a progressively insidious threat,impacting both the quality of life and survival rates.Modern research believes that the disruption of the osteoblast-osteoclast equilibrium is the primary pathological mechanism underlying osteoporosis.Factors such as compromised immunity,microvascular network damage,renal dysfunction,and metabolic disorders also play a role in the pathogenesis.The disruption of the osteoblast-osteoclast equilibrium is akin to the concept of yin and yang imbalance in traditional Chinese medicine.The deficiency of yin and essence in the kidney,which governs bone marrow,leads to marrow sea insufficiency and bone atrophy over time due to the deficiency in both yin and yang.Therefore,chronic kidney disease complicated by osteoporosis stems from the dysfunction of yang transforming qi while yin constituting form,giving rise to blood stasis and other pathological manifestations.Professor Li Yuejin treats chronic kidney disease complicated by osteoporosis according to the principle of reinforcing kidney yang and supplementing essence and replenishing marrow.On this basis,Professor Li adopts the method of invigorating spleen and tonifying middle to invigorate the source of yang as well as activating blood and resolving stasis to unblock yang channels,yielding positive clinical outcomes.This review is expected to offer novel treatment perspectives for chronic kidney disease complicated by osteoporosis.
作者
郝菲杨
李跃进
HAO Feiyang;LI Yuejin(Shanxi University of Chinese Medicine,Taiyuan 030024,China;Shanxi Provincial Integrated TCM and WM Hospital Affiliated to Shanxi University of Chinese Medicine,Taiyuan 030013,China)
出处
《基层中医药》
2025年第5期1-6,共6页
Basic Traditional Chinese Medicine
基金
山西省中医药管理局科研课题计划(2023YYC036)。
关键词
慢性肾脏病
骨质疏松
阳化气
阴成形
扶阳法
chronic kidney disease
osteoporosis
yang transforming qi
yin constituting form
yang-reinforcing method
