基于“肾生髓、髓生血”理论治疗地中海贫血  

Based on Theory of“Kidney Stores Essence and Generates Marrow,and Marrow Generates Blood”to Treat Thalassemia

作　　者：吴志奎[1] 张新华[2] 方素萍[1] 王文娟[1] 王蕾[1] 李敏[1] 王荣新[2] 刘咏梅[1] 柴立民[1] 张冲[1] 刘莉[1] 程艳玲[1] 褚娜利[1] 

机构地区：[1]中国中医科学院广安门医院,北京100053 [2]解放军第三○三医院,南宁530021

出　　处：《世界中医药》2014年第6期717-721,共5页World Chinese Medicine

基　　金：国家重点基础研究发展计划:("973"计划)资助项目(编号:2010CB530406);国家自然基金资助项目(编号:81173167;904090039重大;301711990;39270857);新药专项基金资助项目(编号:2009ZX09301-005-2-7)

摘　　要：地中海贫血是因先天性基因缺陷致使珠蛋白合成障碍引起的一种遗传性血液病,也叫珠蛋白合成障碍性贫血。它是世界上发病率高、危害最大的单基因遗传病,至今尚无有效的治疗方法。中国中医科学院广安门医院根据肾藏精生髓、髓生血理论,在广西高发区,用补肾益髓法治疗地中海贫血600余例,取得了肯定疗效。论文探讨了中药治疗地中海贫血的证治规律,总结了近30年的临床实践,提出了中医治疗地中海贫血的理论基础和中医核心病机假说,形成了系统的理论与有效治法。依托多项国家基金,从整体效应、基因突变与疗效关系、骨髓有效造血、红细胞结构与功能、调控珠蛋白mRNA表达等不同层面,探讨了中药治疗地中海贫血疗效特点和作用靶点的分子机制,使中药治疗地中海贫血整体水平达到新的高度。研究结果将从一个侧面揭示"肾藏精"及"与肾相关"疾病的内在关系。从"肾"论治地中海贫血的临床与基础研究成果,为阐释"肾藏精"脏象理论的科学内涵提供了有说服力的证据。Thalassemia is a common and hazard monogenic inherited hematologic disease with high morbidity in the world,which is caused by gene mutation or defect in the synthesis of one or more of the hemoglobin chains.So far,there has been found no special effec-tive measures for the treatment of thalassemia.According to the traditional Chinese medicine theory“kidney generates marrow,and mar-row generates blood”,Prof.Wu treated 600 thalassemia patients in Guangxi where the disease frequently occurs with the method of toni-fying kidney and benefiting marrow and gained positive effects.The paper summarized the clinical practices of last 30 years,discussed the regular pattern about the treatment by traditional Chinese medicine on thalassemia,and thus put forward the hypothesis of TCM core pathogenesis of thalassemia as well as the possibility of treatment according to the core pathogenesis based on the basic theory and thera-peutic principles of thalassemia.The clinical practice and intensive mechanism study on the effects further proved the effectiveness of the TCM theory “kidney produces marrow,and marrow produces blood”in curing thalassemia.Depending on many national funds,we have studied the molecular mechanism of treating thalassemia by traditional Chinese medicine,including the overall effects,the relationship be-tween clinical effect and gene mutation,bone marrow hematopoiesis,the structure and function of red blood cells as well as RNA expres-sion of related globins and thus achieved a new level for curing thalassemia by Chinese traditional medicine .The clinical and basic re-search works revealed from another aspect the internal relationship between the theory”kidney produces marrow”and diseases related to kidney,and thus provided powerful proof to clarify the scientific essence for the theory “kidney produces marrow”.

关 键 词：肾藏精生髓 髓生血 地中海贫血 临床 核心病机 益髓生血颗粒 

分 类 号：R255.7[医药卫生—中医内科学]