从燮理肝脾肾治疗绝经后骨质疏松症探讨  

Treatment of postmenopausal osteoporosis by regulating liver,spleen and kidney

作　　者：陈巨鹏[1] 严晓莺 黄国淳[1] 邢润麟 CHEN Jupeng;YAN Xiaoying;HUANG Guochun(Jiangsu Provincial Hospital of Traditional Chinese Medicine,Affiliated to Nanjing University of Traditional Chinese Medicine,Nanjing 210029)

机构地区：[1]南京中医药大学附属江苏省中医院,南京210029 [2]南京农业大学工学院,南京210031

出　　处：《陕西中医》2020年第11期1635-1638,共4页Shaanxi Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金资助青年项目(81804123);第四批全国中医优秀人才研修项目(国中医药人教发[2017]24号);江苏省中医药科技发展计划项目(YB201919)。

摘　　要：绝经后骨质疏松症(PMPO)是发生于女性绝经期的代谢性骨病,又称Ⅰ型原发性骨质疏松症,以腰背疼痛无力、脊柱驼背变形、易于跌倒骨折为主要临床表现。属中医“骨痿”“骨枯”范畴。从中医整体观出发分析本病的发生与肝脾肾失调相关,病理机制有:肾虚为本,先天亏虚;脾虚失用,后天乏源;肝郁血虚,枢机不利;血瘀为标,瘀虚互生。其病机为本虚标实证,本虚在于肝脾肾精气亏虚、骨失濡养;标实责之肝郁血瘀、骨络失和。治疗大法应当标本同治、扶正祛邪,燮理肝脾肾;经验方补肾活血健骨方从“补肾填髓、健脾益气、疏肝理气、活血祛瘀”立法,契合PMOP病机,获得一定临床疗效。Postmenopausal osteoporosis(PMPO)is a metabolic bone disease that occurs in women during menopause,also known as type I primary osteoporosis.The main clinical manifestations of PMPO include low back pain and weakness,kyphosis deformation and prone to fall fracture.It belongs to the category of“bone flaccidity”and“bone withering”in traditional Chinese medicine.From the holistic view of traditional Chinese medicine,the pathogenesis of this disease is related to liver,spleen and kidney imbalance.The pathological mechanisms are as follows:kidney deficiency as the root,congenital deficiency;spleen deficiency and deficiency,acquired lack of source;liver depression and blood deficiency,the axis is unfavorable;blood stasis as the standard,blood stasis and deficiency of each other.The pathogenesis of the disease is based on deficiency and excess syndrome,This deficiency lies in the deficiency of essence and Qi of liver,spleen and kidney,external is liver depression and blood stasis.The treatment method should treat both the root and the root,support the healthy and eliminate pathogenic factors,and regulate the liver,spleen and kidney;the empirical prescription of Bushen Huoxue Jiangu should legislate from“tonifying the kidney and filling the marrow,strengthening the spleen and Qi,soothing the liver and regulating Qi,promoting blood circulation and removing blood stasis”,which conforms to the pathogenesis of PMOP and achieves certain clinical efficacy.

关 键 词：绝经后骨质疏松症 辨证论治 肝脾肾 补肾填髓 健脾益气 疏肝理气 

分 类 号：R271.116[医药卫生—中医妇科学]