中医“肾主骨”理论与肾性骨病刍议  

Discussion on“kidney governing bones”theory and renal osteodystrophy

作　　者：张浩 舒冰[1,2,3] 李晓锋[1,2,3] 王晶 赵世天[1,2,3] 杨骏杰[1,2,3] 赵东峰 赵永见[1,2,3] 王拥军[2,3,4] ZHANG Hao;SHU Bing;LI Xiaofeng;WANG Jing;ZHAO Shitian;YANG Junjie;ZHAO Dongfeng;ZHAO Yongjian;WANG Yongjun(Longhua Hospital Affiliated to Shanghai University of Tadionl Chine Medicine,Shanghai 200032,China;Spine Insititute Shanghai University of Tradtioanl Chinese Medine.,Shanghai 200032 China;Key Laloalor of Thery and Therpy of Museles and Bones.Ministry of Education,Shanghai 200032,China;Shanghai University of Tradtional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海中医药大学附属龙华医院,上海200032 [2]上海中医药大学脊柱病研究所,上海200032 [3]教育部(筋骨理论与治法)重点实验室,上海200032 [4]上海中医药大学,上海201203

出　　处：《上海中医药大学学报》2020年第6期81-87,共7页Academic Journal of Shanghai University of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(81673991,81973876);国家重点研发计划项目(2018YFC1704300);上海市重中之重临床医学中心建设项目(2017ZZ01010);上海市中医药事业发展三年行动计划项目[ZY(2018-2020)-CCCX-3003];上海市卫计委科研项目(20174Y0192);教育部创新团队发展计划项目(IRT1270);上海中医药大学杏林学者项目。

摘　　要：中医"肾主骨"理论是中医脏腑理论的核心内容之一,在防治骨与关节退变性和衰老性疾病方面具有重要理论和临床价值。肾精亏虚,骨髓化源不足,骨骼失养会导致多种骨病的发生,因而从"肾"论治骨病成为历代医家沿用的治病法则。肾性骨营养不良(简称"肾性骨病")是指由慢性肾脏病引起的体内矿物质和骨代谢紊乱,导致骨转化、矿化以及骨量改变的疾病。由于肾精亏虚是肾性骨病的重要病机之一,补肾方药对于改善骨代谢异常具有重要作用。研究表明,补肾中药可以有效改善患者肾功能,减轻骨代谢和钙磷代谢紊乱,从而改善骨病症状,但如何鉴别补肾中药的作用靶点和机制,进一步优化和精简补肾复方,并在肾性骨病的早期积极干预,仍是有待解决的科学问题。The"kidney governing bones"theory in traditional Chinese medicine is one of the core contents of zang-fu viscera theories,which shows important theoretical and clinical values in the prevention and treatment of bone and joint degeneration as well as senile diseases.Deficiency of kidney essence leads to insufficient source of bone marrow,which failures to nourish bones,and thus induces various bone diseases.Therefore,the treatment of bone diseases based on"kidney"has become the therapeutic principle used by physicians in all ages.Renal osteodystrophy refers to the disorder of mineral and bone metabolism caused by chronic kidney diseases,which leads to changes in bone transformation,mineralization and bone mass.Deficiency of kidney essence is one of the critical pathogenesis of renal osteopathy,so medicines and prescriptions of tonifying kidney play an important role in improving the abnormal bone metabolism.Researches have revealed that Chinese medicines for tonifying kidney can effectively improve the renal function of patients,alleviate the disorder of bone metabolism as well as calcium and phosphorus metabolism,and improve the symptoms of osteopathy.However,how to identify the targets and mechanisms of kidney tonifying herbs,further optimize and simplify the compound recipes,and actively intervene in the early stage of renal osteopathy,are still scientific problems to be solved.

关 键 词：肾主骨 肾性骨病 骨代谢 补肾法 

分 类 号：R277.5[医药卫生—中医学]