摘要
非创伤性股骨头坏死(NONFH)作为骨科难治性疾病,目前其发病机制尚未完全阐明。中医学认为,瘀毒作为NONFH病理基础,瘀血阻滞、毒邪内生,瘀毒互结、骨蚀髓空是疾病发生发展的主要病因病机;现代医学研究发现,铁过载可通过诱导氧化应激、脂质过氧化及血管内皮损伤等途径导致骨细胞死亡、骨结构破坏。铁过载状态下,过量的游离铁催化活性氧(ROS)生成及其加速NONFH发生的机制与“瘀毒”病机相契合,通过引发骨微环境失衡,加重缺血和瘀血状态,最终形成瘀毒互结的病理循环。该文通过整合瘀毒理论与铁过载机制,探讨“瘀毒”理论在NONFH铁过载机制中的作用,提出NONFH的发生可能与“铁过载-瘀毒-非创伤性股骨头坏死”机制密切相关,可为NONFH理论研究及临床防治提供新的思路。
Non-traumatic osteonecrosis of femoral head(NONFH)remains a refractory orthopedic disease with incompletely elucidated pathogenesis.Traditional Chinese medicine theory posits that stasis-toxin constitutes the pathological basis of NONFH,where blood stasis obstruction and endogenous toxin accumulation interact,leading to toxin blended with stasis,bone erosion and marrow depletion as the primary etiology and pathogenesis.Modern medical research has revealed that iron overload induces osteocyte death and bone structure destruction through pathways including oxidative stress,lipid peroxidation,and vascular endothelial damage.Under iron overload conditions,excessive free iron catalyzes reactive oxygen species(ROS)generation,accelerating NONFH progression-a mechanism aligning with the"stasis-toxin"pathogenesis pattern.By triggering imbalance in the bone microenvironment and exacerbating ischemic and stasis conditions,it ultimately forms a pathological cycle of stasis blended with toxin.This paper integrates stasis-toxin theory with iron overload mechanisms to explore the role of"stasis-toxin"theory in NONFH iron overload pathogenesis,proposing that NONFH development may be closely related to the"iron overload-stasistoxin-NONFH"mechanism,potentially providing new perspectives for theoretical research and clinical prevention of NONFH.
作者
张洪健
丁龙龙
廖家俊
刘博
陈志健
张桂鑫
龚春柱
ZHANG Hongjian;DING Longlong;LIAO Jiajun;LIU Bo;CHEN Zhijian;ZHANG Guixin;GONG Chunzhu(Shenzhen Pingle Orthopedic Hospital Affiliated to Guangzhou University of Chinese Medicine,Shenzhen Guangdong 518010,China;Shenzhen Pingle Orthopedic Hospital/Shenzhen Pingshan Traditional Chinese Medicine Hospitial,Shenzhen Guangdong 518010,China)
出处
《新中医》
2026年第2期103-109,共7页
New Chinese Medicine
基金
广东省中医药局科研项目(20231290)
深圳市“医疗卫生三名工程”项目资助(SZZYSM202311020)
深圳市坪山区卫生健康系统科研项目(2024135)。
关键词
非创伤性股骨头坏死
“瘀毒”理论
铁过载
炎症反应
中医内涵
Non-traumatic osteonecrosis of femoral head
"Stasis-toxin"theory
Iron overload
Inflammatory response
Traditional Chinese medicine connotation
