基于肾虚精亏理论探讨类风湿关节炎骨破坏的发生发展机制  

Mechanism of Bone Destruction in Rheumatoid Arthritis Based on the Theory of Kidney Deficiency and Essence Deficiency

作　　者：朱文菊 苏小军[2] 何倩 王欢 张志明 沈海丽[3] 叶孝涛 ZHU Wenju;SU Xiaojun;HE Qian;WANG Huan;ZHANG Zhiming;SHEN Haili;YE Xiaotao(Gansu University of Chinese Medicine,Lanzhou,730030;Gansu Provincial Hospital of Traditional Chinese Medicine;Lanzhou University No.2 Hospital)

机构地区：[1]甘肃中医药大学,甘肃省兰州市730030 [2]甘肃省中医院 [3]兰州大学第二医院

出　　处：《中医杂志》2024年第19期2045-2049,共5页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(82260880);甘肃省自然科学基金(22JR5RA626);甘肃省中医药管理局重点科研项目(GZKZ-2021-3)。

摘　　要：类风湿关节炎以持续性滑膜炎、血管翳的形成为特征性病理改变,晚期可出现不可逆的骨关节破坏和变形。提出肾虚精亏为类风湿关节炎骨破坏的核心病机,其疾病演变为“髓减、肉痿、络阻”,并据此梳理类风湿关节炎骨破坏的现代医学认识,认为“髓减、肉痿、络阻”终使骨破坏的中医病机与破骨细胞异常分化、核因子-κB受体活化因子配体的高表达及炎症因子异常分泌的西医机制有相通之处,可为全面且科学地阐释类风湿关节炎骨破坏的病理机制提供参考。Rheumatoid arthritis is a common clinical autoimmune disease characterized by persistent synovitis and pannus formation.In late stage,irreversible destruction and deformation of bone and joint may occur.In this paper,the authors believe that kidney deficiency and essence deficiency is the core mechanism of rheumatoid arthritis bone destruction,and its disease evolution law is summarized as"marrow reduction,flesh flaccid,collaterals blocked".On the basis of modern medical understanding of bone destruction in rheumatoid arthritis,it is considered that the mechanism in Chinese medicine of"marrow reduction,flesh flaccid,collaterals blocked"ultimately leads to bone destruction,is similar to that in the western medicine of abnormal differentiation of osteoclasts,high expression of nuclear factor-κB receptor activator of ligand,and abnormal expression of inflammatory factors.This point of view may provide a more comprehensive and scientific understanding of the key pathogenic mechanism of bone destruction in rheumatoid arthritis.

关 键 词：类风湿关节炎 骨破坏 肾虚精亏 骨枯髓减 肌骨失衡 痰湿瘀阻 

分 类 号：R259[医药卫生—中西医结合]