摘要
基于体脏合痹理论,系统探讨类风湿关节炎(RA)并发肌少症的中医病机演化规律,提出“肌痹→脾痹→痿痹”的传变路径,认为营卫失和是贯穿始终的核心病机。并结合现代分子生物学研究,提出肿瘤坏死因子样弱凋亡诱导蛋白-成纤维细胞生长因子14(TWEAK-Fn14)轴介导的骨骼肌稳态失衡可能是该病机演化的物质基础。在此基础上,进一步提出“调补营卫、温阳行痹、以体养脏”与“运脾化浊、清热通痹、调脏安体”的中医治疗策略,强调体脏同治、防治结合,以此为RA并发肌少症的中医药防治提供理论依据与临床思路。
Based on the theory of'bi(痹)of both body and viscera',this paper systematically discussed the pathogenic evolution of rheumatoid arthritis(RA)complicated by sarcopenia from the perspective of traditional Chinese medicine(TCM).It is proposed that a transformation pathway is muscle bi to spleen bi and then atrophy bi,and the core pathogenesis is diaharmony of ying(营)and wei(卫).Combining modern molecular biology research,it is suggested that imbalances in skeletal muscle homeostasis mediated by the tumor necrosis factor-like weak inducer of apoptosis-ibroblast growth factor-inducible 14(TWEAK-Fn14)axis may provide the material basis for the evolution of this disease.Furthermore,this authors proposed TCM treatment strategies,including"regulating and tonifying ying and wei,warming yang and moving bi,nourishing the viscera by supporting the body",and"promoting the spleen and resolving turbidity,clearing heat and promoting circulation,regulating the organs and calming the body".These strategies emphasize the simultaneous treatment of body and viscera,integrated prevention and treatment,so as to provide TCM theoretical foundation and clinical approaches for preventing and treating RA complicated by sarcopenia.
作者
钟帅
姜萍
赵啸虎
刘源
田轩赫
ZHONG Shuai;JIANG Ping;ZHAO Xiaohu;LIU Yuan;TIAN Xuanhe(First Clinical Medical College,Shandong University of Traditional Chinese Medicine,Jinan,250014;Affiliated Hospital of Shandong University of Traditional Chinese Medicine)
出处
《中医杂志》
北大核心
2025年第23期2443-2446,2466,共5页
Journal of Traditional Chinese Medicine
基金
国家自然科学基金(82274481,81874449)
国家中医药管理局科技司共建项目(GZY-KJS-SD-2023-041)
山东省自然科学基金(ZR2022LZY004)
山东省卫生健康科创团队建设项目。
关键词
类风湿关节炎
肌少症
体脏合痹
营卫失和
痹病
痿证
rheumatoid arthritis
sarcopenia
bi(痹)of both body and viscera
disharmony of ying(营)and wei(卫)
bi(痹)disease
atrophy syndrome
