基于本虚标实之辨分期论治肝性骨病  

Treatment of Hepatic Osteodystrophy by Stages based on Root Deficiency and Branch Excess

作　　者：董海航 蔡雨洁 王冬凌 张引强[1] DONG Haihang;CAI Yujie;WANG Dongling;ZHANG Yinqiang(Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing,100091;Shanxi University of Traditional Chinese Medicine)

机构地区：[1]中国中医科学院西苑医院,北京市海淀区100091 [2]山西中医药大学

出　　处：《中医杂志》2023年第23期2471-2475,共5页Journal of Traditional Chinese Medicine

基　　金：中国中医科学院创新工程课题(CI2021A00805);中国中医科学院西苑医院“青师计划”项目;全国中医特色临床技术传承人才支持项目。

摘　　要：肝性骨病当辨明本虚标实而分期论治。肝性骨病发病之本在肝、脾、肾三脏不足,而起病之标应分期而辨,隐匿期在少阳郁闭、枢机不利,发作期在浊毒瘀热、灼髓枯骨。治疗上当注重调补肝、脾、肾之虚损以培本筑基,隐匿期需注重畅达少阳肝胆之枢机以和调气血,发作期重在化瘀黜浊清源以利胆强骨,临床需根据个体症状增减用药,分清标本主次以紧扣病机,随证化裁,同时强调合理安全用药,保护肝脏功能。Hepatic osteodystrophy(HO)should be treated by stages based on the differentiation of root deficiency and branch excess.The root cause of HO is the insufficiency of the liver,spleen,and kidney,and the branch onset should be differentiated by stages that in the incubation,the pathogenesis is shaoyang(少阳)constraint and block and cardinal disturbance,while in the attack period,it is turbid toxin,static heat,scorching marrow and withering bones.In treatment,attention should be paid to regulating and tonifying the depletion of the liver,spleen,and kidney to cultivate the foundation.In the incubation period,it is suggested to put focus on unblocking cardinal disturbance of shaoyang liver and gallbladder so as to regulate and harmonize qi and blood.In the attack period,the focus should be on dissolving stasis,removing turbidity,and clearing the source to promote gallbladder function and bone strength.In clinical practice,medication should be modified according to individual symptoms,and the root and the branch,the primary and the secondary should be differentiated to closely follow the pathogenesis and be tailored according to the symptoms.At the same time,reasonable and safe medication should be emphasized to protect liver function.

关 键 词：肝性骨病 骨质疏松症 本虚标实 

分 类 号：R259[医药卫生—中西医结合]