基于国医大师刘柏龄“肾主骨”理论仙灵健骨汤治疗骨质疏松症临证经验  

Clinical experience of Xianling Jiangu Decoction in the treatment of osteoporosis based on the theory of"kidney governing bone"of Chinese medicine master Liu Bailing

作　　者：王卓尔 黄婉欣 马锌 张维 WANG Zhuoer;HUANG Wanxin;MA Xin;ZHANG Wei(Changchun University of Chinese Medicine,Changchun 130117,China;Jilin Cancer Hospital,Changchun 130021,China;Third Affiliated Hospital of Changchun University of Chinese Medicine,Changchun 130117,China)

机构地区：[1]长春中医药大学,长春130117 [2]吉林省肿瘤医院,长春130021 [3]长春中医药大学附属第三临床医院,长春130117

出　　处：《吉林中医药》2025年第3期299-302,共4页Jilin Journal of Chinese Medicine

基　　金：吉林省教育厅科学技术项目(JJKH20241048KJ)。

摘　　要：骨质疏松症是以骨量降低、骨微结构破坏为特征的全身性骨代谢疾病,其核心病理机制涉及骨重建失衡与钙磷代谢异常。中医认为肾精亏虚、脾失健运致骨髓失养是发病关键。首届国医大师刘柏龄基于“肾主骨生髓”理论,提出“治肾亦即治骨”的学术思想,强调肾中阴阳互济对骨骼代谢的调控作用,注重后天脾胃对先天之精的滋养功能。脾肾阳虚是老年性骨质疏松的核心病机,病机演化呈现“肾虚髓减-脾虚失运-气血瘀滞”的传变规律。张维教授针对此证型创制的仙灵健骨汤,温肾壮阳,填精益髓,补肾强骨,活血通络,健脾益气,形成补肾为主,脾肾双补,通补兼施的组方特色。Osteoporosis is a systemic bone metabolic disease characterized by decreased bone mass and destruction of bone microstructure.Its core pathological mechanism involves imbalance of bone remodeling and abnormal calcium and phosphorus metabolism.Traditional Chinese medicine classifies it into the category of"bone atrophy",and holds that bone marrow dystrophy caused by kidney essence deficiency and spleen dysfunction is the key to its pathogenesis.Based on the theory of"the kidney governing the bone and generating marrow",Professor Liu Bailing,master of traditional Chinese medicine,puts forward the academic thought of"treating the kidney equating treating the bone",emphasizing the regulatory effect of the mutual benefit of yin and yang in the kidney on bone metabolism,and paying attention to the nourishing function of the spleen and stomach on the congenital essence.Clinical practice has found that spleen and kidney yang deficiency is the core pathogenesis of senile osteoporosis.Its typical syndromes are cold pain in waist and knees,aversion to cold and cold limbs,and poor appetite and loose stools.The evolution of its pathogenesis presents a transmission pattern of"kidney deficiency and marrow reduction-spleen deficiency and failure in its transportation function-depressed qi and stagnant blood stasis".Professor Zhang Wei crafts Xianling Jiangu Decoction for this syndrome,with epimedium herb,prepared rehmannia root and Chinese yam as the sovereign drugs to warm the kidney and strengthen yang,replenish essence and benefit marrow,compatible with eucommia bark,Himalayan teasel root and desertliving cistanche to strengthen the function of tonifying the kidney and strengthening the bone,with keel,oyster shell to enhance yang while suppress hyperactive yang,with frankincense,myrrh and suberect spatholobus stem to promote blood circulation and to remove obstructions in collaterals,to invigorate the spleen and to replenish qi.The prescription is characterized by placing a priority on tonifying the kidney,invigorating the sp

关 键 词：仙灵健骨汤 骨质疏松症 刘柏龄 

分 类 号：R274[医药卫生—中医骨伤科学]