基于“活血生骨”理论探讨激素性股骨头坏死的中医论治  

Discussion on the Traditional Chinese Medicine Treatment of Steroid-Induced Avascular Necrosis of the Femeral Head Based on the Theory of “Activating Blood and Promoting Bone”

作　　者：严锦贤[1,2] 宋红梅 张宽[1,2] 郑文炜 周季萱[1,2] 倪立坚 王和鸣 

机构地区：[1]福建中医药大学附属第二人民医院,福建 福州 [2]福建省医疗机构中药制剂重点实验室,福建 福州 [3]福建中医药大学,福建 福州

出　　处：《中医学》2024年第3期390-396,共7页Traditional Chinese Medicine

摘　　要：激素性股骨头坏死(SANFH)是一种由长期或大剂量应用糖皮质激素引发的疾病,机制不清,危害极大。本文旨在探讨王和鸣教授提出的“活血生骨”理论在SANFH治疗中的应用和科学内涵。首先,回顾了SANFH的中医病因病机和现代致病机制,强调脾肾亏虚、痰瘀互结等中医病因在SANFH发病中的重要作用。然后,详细阐述“活血生骨”理论与传统“补益肝肾、活血化瘀”治则的关系,以及其与现代医学“成血管–成骨偶联”理论在治疗SANFH上的深度相互关联和作用。最后,总结基于“活血生骨”理论的中药复方在治疗SANFH方面的显著效果以及作用机制。本文的研究结果为后续SANFH的防治研究和新药研发提供了理论参考和借鉴,强调了中医“活血生骨”理论在SANFH治疗中的重要指导意义。Steroid-Induced Avascular Necrosis of the Femeral Head (SANFH) is a disease caused by long-term or high-dose application of glucocorticoids. The mechanism is unclear and it is extremely harmful. This article aims to explore the application and scientific connotation of the “activating blood and promoting bone” theory proposed by Professor Wang Heming in the treatment of SANFH. First, the TCM etiology and modern pathogenic mechanisms of SANFH are reviewed, emphasizing the im-portant role of TCM etiology such as spleen and kidney deficiency, phlegm and blood stasis in the pathogenesis of SANFH. Then, the relationship between the theory of “activating blood and promot-ing bone” and the traditional treatment principle of “tonifying the liver and kidneys, promoting blood circulation and removing blood stasis” is elaborated, as well as its deep correlation and effect with the modern medical “angiogenesis-osteogenesis coupling” theory in the treatment of SANFH. Finally, the significant effects and mechanisms of traditional Chinese medicine compounds based on the theory of “activating blood and promoting bone” in the treatment of SANFH are summarized. The research results of this article provide theoretical reference and reference for subsequent pre-vention and treatment research on SANFH and the development of new drugs, emphasizing the im-portant guiding significance of the traditional Chinese medicine theory of “activating blood and promoting bone” in the treatment of SANFH.

关 键 词：激素性股骨头坏死 活血生骨 病因病机 王和鸣 成血管–成骨偶联 

分 类 号：R68[医药卫生—骨科学]