摘要
股骨头坏死属于"痹证""骨痹""骨蚀"范畴,是骨伤科常见病及多发病,严重影响患者生活质量,严重者需经手术治疗保存肢体活动功能。但发病机制尚不明确。近年来中医药治疗股骨头坏死优势日趋明显,中医以整体思维、辨证论治为理论指导,临床疗效显著。目前多数学者认为该病多为本虚标实,肝肾亏虚为本,血瘀、气滞、痰阻等为标,与脾、肝、肾等藏关系密切。临床常用方剂根据上述理论基础,以肝肾亏虚、脾肾阳虚、痰瘀阻滞、湿热蕴结、气滞血瘀及肾虚血瘀为基础分型,辨证论治,取得良好临床效果。又有学者应用基础方,结合不同辨证分型结果,随证加减药味及剂量,也取得良好效果。但是限于中医"辨证论治"等理论影响,目前尚缺乏统一、公认的治疗方案,故未来应在开展多中心、大样本临床研究基础上,重点突出基础理论研究,获取理论支持。
Osteonecrosis of the femoral head belongs to the category of"arthralgia","osteoarthralgia"and"osteoerosion"in traditional Chinese medicine.It is a common and frequently-occurring disease in orthopedics and traumatology,which seriously affects the quality of life of the patients.The patients with severe osteonecrosis need operation to preserve the function of limb movement.But the pathogenesis is not clear.In recent years,the advantages of traditional Chinese medicine in the treatment of osteonecrosis of the femoral head have become increasingly obvious.Traditional Chinese medicine is guided by the theory of holistic thinking as well as syndrome differentiation and treatment with significant clinical effect.At present,most scholars think that the disease is mainly caused by deficiency in origin and excess in superficislity,which means origin deficiency in liver and kidney,superficislity in blood stasis,Qi stagnation and phlegm obstruction which are closely related to the spleen,liver and kidney.According to the above theoretical basis,the commonly-used clinical prescriptions are divided into these types:deficiency of liver and kidney,Yang deficiency of spleen and kidney,stagnation of phlegm and blood stasis,accumulation of dampness and heat,stagnation of Qi and blood stasis,and deficiency of kidney and blood stasis.After syndrome differentiation and treatment,it achieves good clinical effect.In addition,some scholars apply the basic formula and adjust the formula and dosage in accordance with the syndrome,and it also achieves good results.However,due to the theoretical influence of"syndrome differentiation and treatment"in traditional Chinese medicine,there is still a lack of unified and recognized treatment plan.Therefore,it ought to be focused on the basic theoretical research and theoretical support obtaining on the basis of multi-center and large sample clinical research in the future.
作者
张健
侯德才
ZHANG Jian;HOU Decai(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China)
出处
《实用中医内科杂志》
2020年第5期65-68,共4页
Journal of Practical Traditional Chinese Internal Medicine
基金
辽宁省科学技术基金(201702023-201)。
关键词
股骨头坏死
中医
内服方剂
组方分析
证型
辨证论治
osteonecrosis of femoral head
traditional Chinese medicine
oral prescription
composition analysis
syndrome type
syndrome differentiation and treatment
