基于奇经和络病理论探讨杜氏型肌营养不良中医发病机制  

Exploring the TCM pathogenesis of Duchenne muscular dystrophy based on the theory of extra meridians and collateral disease

作　　者：梁亚飞 杨勇(综述) 陆春玲(审校)[1] Liang Yafei;Yang Yong;Lu Chunling(Department of Muscle Atrophy,Hebei Yiling Hospital,Hebei,Shijiazhuang 050091,China)

机构地区：[1]河北以岭医院肌萎缩科,石家庄050091

出　　处：《疑难病杂志》2025年第3期381-384,共4页Chinese Journal of Difficult and Complicated Cases

基　　金：河北省中医药管理局科研计划项目(2023180,2023184,2020245)。

摘　　要：杜氏型肌营养不良(DMD)以对称性肢体肌萎无力为主要表现,是遗传性肌肉变性病,属中医“痿证”范畴。脏腑辨证理论认为肢体之肌、筋、骨为脾、肝、肾所主,故肌肉筋骨萎软不用与脾、肝、肾虚损关系密切。但DMD症状繁多、进行性发展、病机复杂,且疾病初期虽有严重肌萎无力,却无脏腑受累典型症状,难用脏腑虚损去分析其临床特点及发病机制。文章基于奇经和络病理论,探讨DMD中医发病机制,提出先天不足是其发病之根本,奇经虚损是其症状启动之机括,络脉病变是病情进展之要素,而络息成积是本病后期心肺功能衰竭的关键。Duchenne muscular dystrophy(DMD)is characterized by symmetrical limb weakness,which is a hereditary muscle degenerative disease and belongs to the category of"flaccidity syndrome"in traditional Chinese medicine.According to the theory of zang-fu syndrome differentiation,the muscles,tendons and bones of the limbs are dominated by the spleen,liver and kidney,so the weakness of the muscles,tendons and bones is closely related to the deficiency of the spleen,liver and kidney.However,Duchenne muscular dystrophy has various symptoms,progressive development and complex pathogenesis,and although there is severe muscle weakness in the early stage of the disease,there is no typical symptom of viscera involvement,so it is difficult to analyze its clinical characteristics and morbidity mechanism by viscera deficiency.Based on the theory of extra meridians and collateral disease,this paper discusses the mechanism of morbidity in traditional Chinese medicine(TCM)of Duchenne muscular dystrophy(DMD),and proposes that congenital deficiency is the root of morbidity,the deficiency of extra meridians is the mechanism of symptom initiation,the lesion of collaterals is the factor of disease progression,and the accumulation of collaterals is the key to cardiopulmonary failure in the late stage of the disease.

关 键 词：杜氏型肌营养不良 痿证 中医病机 奇经八脉 络脉病变 

分 类 号：R255.6[医药卫生—中医内科学]