从“骨络疏失”论治老年骨质疏松症  

On Treatment of Senile Osteoporosis Based on the Theory of"Bone Collateral Deficiency and Disruption"

作　　者：郭冰玉 许成勇 李彦 谢一涵 李佳航 黄振俊 GUO Bingyu;XU Chengyong;LI Yan;XIE Yihan;LI Jiahang;HUANG Zhenjun(Hainan Hospital of the Chinese People′s Liberation Army General Hospital,Sanya,Hainan,China,572013)

机构地区：[1]中国人民解放军总医院海南医院,海南三亚572013

出　　处：《河南中医》2025年第5期667-670,共4页Henan Traditional Chinese Medicine

基　　金：海南省自然科学基金面上项目(823MS159)。

摘　　要：骨质疏松症病位在骨,根本在肾,老年人肾气虚衰,真阴真阳亏虚,导致骨髓化源不足,对骨骼的滋养能力减弱,络脉必亏,肾气虚衰,气络不充为发病基础。血为气之母,气为血之使,气虚则血虚,骨络窄小微细,血液亏虚,凝聚成瘀,瘀血阻塞不通,气无以流通,久而耗气伤血,导致络中瘀血再生,瘀血与气虚、血虚互为因果,形成恶性循环,致病情缠绵难愈。骨络数量减少或形态变细,即为骨络疏,骨络疏进一步发展,则成为骨络失。治疗应在补益肾精的同时,畅通血络、恢复络脉正常功能,骨络疏时可侧重于活血法,以促进瘀血阻塞的血管再通;骨络失时可采用补肾法,以改善骨络之失,方常用滋肾骨康丸加减。Osteoporosis is rooted in the bone but fundamentally linked to the kidney.In the elderly,deficiency of kidney qi and depletion of genuine yin and yang lead to insufficient marrow production,weakened nourishment of bones,and inevitable deficiency of collateral vessels.The deficiency of kidney qi and inadequacy of qi-collateral serve as the pathological foundation.Blood acts as the mother of qi,while qi drives blood circulation.Qi deficiency results in blood deficiency,narrowing of bone collaterals,and blood stasis due to insufficient blood volume.Stasis blocks the flow of qi,leading to prolonged consumption of qi and blood,which further regenerates stasis within collaterals.The vicious cycle between blood stasis,qi deficiency,and blood deficiency causes persistent and refractory symptoms.Reduction in the number or thinning of bone collaterals is regarded as bone collateral deficiency.Progressive deterioration of this condition evolves into bone collateral disruption.Treatment should focus on replenishing kidney essence while unblocking blood collaterals and restoring normal collateral function.During the bone collateral deficiency stage,emphasis should be placed on activating blood circulation to promote revascularization of stasis-blocked vessels.During the bone collateral disruption stage,the kidney-tonifying method should be adopted to repair bone collateral damage,so Kidney-Tonifying and Bone-Strengthening Pill can be adopted.

关 键 词：老年骨质疏松症 “骨络疏失” 滋肾骨康丸 

分 类 号：R274.981[医药卫生—中西医结合]