[1]魏秋实,何伟,张庆文,等.基于中医治未病理论探讨新型冠状病毒肺炎后股骨头坏死的防治思路[J].中医正骨,2020,32(03):48-51.
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基于中医治未病理论探讨新型冠状病毒肺炎后股骨头坏死的防治思路()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第32卷
期数:
2020年03期
页码:
48-51
栏目:
学术探讨
出版日期:
2020-03-20

文章信息/Info

作者:
魏秋实1何伟1张庆文2李子祺1洪志楠1陈雷雷1陈镇秋2郑越生3
(1.广州中医药大学第三附属医院,广东 广州 510240; 2.广州中医药大学第一附属医院,广东 广州 510405; 3.广州中医药大学金沙洲医院,广东 广州 510168)
关键词:
股骨头坏死 肺炎病毒性 冠状病毒感染 上工治未病 学术探讨
摘要:
由于糖皮质激素的应用和病毒的影响,新型冠状病毒肺炎患者有并发股骨头坏死的可能。本文基于中医治未病理论,从未病先防和既病防变两个方面对新型冠状病毒肺炎后股骨头坏死的防治思路进行了阐述,提出应重视新型冠状病毒肺炎患者可能出现的血瘀表现,对风险人群进行筛查和随访,及时对患者并发股骨头坏死的可能性及股骨头坏死的程度进行评估,做到早预防、早发现、早治疗,以避免股骨头坏死的发生或发展。

参考文献/References:

[1] 国家卫生健康委员会办公厅,国家中医药管理局办公室.关于印发新型冠状病毒肺炎诊疗方案(试行第七版)的通知:国卫办医函〔2020〕184号[A/OL].(2020-03-04)[2020-03-05].http://www.nhc.gov.cn/yzygj/s7653p/202003/46c9294a7dfe4cef80dc7f5912eb1989.shtml.
[2] XU X,YU C C,QU J,et al.Imaging and clinical features of patients with 2019 novel coronavirus SARS-CoV-2[J].Eur J Nucl Med Mol Imaging,2020.DOI: 10.1007/s00259-020-04735-9.
[3] WANG D W,HU B,HU C,et al.Clinical characteristics of 138 hospitalized patients with 2019 Novel Coronavirus-Infected Pneumonia in Wuhan,China[J].JAMA,2020.DOI:10.1001/jama.2020.1585.
[4] ZHOU W,LIU Y,TIAN D,et al.Potential benefits of precise corticosteroids therapy for severe 2019-nCoV pneumonia[J].Signal Transduct Target Ther,2020.DOI:10.1038/s41392-020-0127-9.
[5] GUAN W J,NI Z Y,HU Y,et al.Clinical characteristics of coronavirus disease 2019 in China[J].N Engl J Med,2020. doi:10.1056/NEJMoa2002032.
[6] HARDY R S,RAZA K,COOPER M S.Therapeutic glucocorticoids:mechanisms of actions in rheumatic diseases[J].Nat Rev Rheumatol,2020,16(3).133-144.
[7] HARDY R S,ZHOU H,SEIBEL M J,et al.Glucocorticoids and bone:consequences of endogenous and exogenous excess and replacement therapy[J].Endocr Rev,2018,39(5):519-548.
[8] CUI L Q,ZHUANG Q Y,LIN J,et al.Multicentric epidemiologic study on six thousand three hundred and ninety five cases of femoral head osteonecrosis in China[J].Int Orthop,2016,40(2):267-276.
[9] GUO K J,ZHAO F C,GUO Y,et al.The influence of age,gender and treatment with steroids on the incidence of osteonecrosis of the femoral head during the management of severe acute respiratory syndrome:a retrospective study[J].Bone Joint J,2014,96-B(2):259-262.
[10] 罗月中,李芸,李勇,等.补肾健骨法预防肾病综合征患者激素性股骨头坏死临床研究[J].中医正骨,2011,23(1):3-6.
[11] XU Z,SHI L,WANG Y J,et al.Pathological findings of COVID-19 associated with acute respiratory distress syndrome[J].Lancet Respir Med,2020.DOI:10.1016/S2213-2600(20)30076-X.
[12] 刘茜,王荣帅,屈国强,等.新型冠状病毒肺炎死亡尸体系统解剖大体观察报告[J].法医学杂志,2020,36(1):1-3.DOI:10.12116/j.issn.1004-5619.2020.01.00.
[13] HUANG C L,WANG Y M,LI X W,et al.Clinical features of patients infected with 2019 novel coronavirus in Wuhan,China[J].Lancet,2020,395(10223):497-506.
[14] CHEN N,ZHOU M,DONG X,et al.Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan,China:a descriptive study[J]Lancet,2020,395(10223):507-513.
[15] 王玉光,齐文升,马家驹,等.新型冠状病毒肺炎中医临床特征与辨证治疗初探[J].中医杂志,2020,61(4):281-285.
[16] 黄雄杰,赖敏,贾春华,等.新型冠状病毒肺炎(NCP)之中医论治观[J].世界中医药,2020,15(2):134-139.
[17] 李非,李盛华,周明旺,等.激素性股骨头坏死发病机制中医理论探析及中医体质研究现状[J].西部中医药,2018,31(2):135-137.
[18] 魏秋实,何伟,张庆文,等.股骨头坏死中医证型分布规律的文献研究和系统评价[J].中华关节外科杂志(电子版),2013,7(3):369-372.
[19] 魏秋实,李子祺,袁颖嘉,等.“标本兼治”理论在股骨头坏死中医药治疗中的指导作用[J].中医正骨,2020,32(1):56-59.
[20] HONG N,DU X K.Avascular necrosis of bone in severe acute respiratory syndrome[J].Clin Radiol,2004,59(7):602-608.
[21] 李子荣. 股骨头坏死成功保髋新理念[J].中医正骨,2018,30(10):1-3.
[22] COHEN-ROSENBLUM A,CUI Q J.Osteonecrosis of the Femoral Head[J].Orthop Clin North Am,2019,50(2):139-149.
[23] SAITO M, UESHIMA K, FUJIOKA M, et al.Corticosteroid administration within 2 weeks after renal transplantation affects the incidence of femoral head osteonecrosis[J].Acta Orthop,2014,85(3):266-270.
[24] 李子荣,孙伟,屈辉,等.皮质类固醇与骨坏死关系的临床研究[J].中华外科杂志,2005,43(16):1048-1053.
[25] OBITSU S,AHMED N,NISHITSUJI H,et al.Potential enhancement of osteoclastogenesis by severe acute respiratory syndrome coronavirus 3a/X1 protein[J].Arch Virol,2009,154(9):1457-1464.
[26] QUEIROZ-JUNIOR C M, SANTOS A C P M, GALVÃO L, et al. The angiotensin converting enzyme 2/angiotensin-(1-7)/Mas Receptor axis as a key player in alveolar bone remodeling[J].Bone,2019,128:115041.
[27] YAN R H,ZHANG Y Y,GUO Y Y,et al.Structural basis for the recognition of the 2019-nCoV by human ACE2[J].bioRxiv,2020.Doi: https://doi.org/10.1101/2020.02.19.956946.
[28] LU R,ZHAO X,LI J,et al.Genomic characterisation and epidemiology of 2019 novel coronavirus:implications for virus origins and receptor binding[J].Lancet,2020,395(10224):565-574.
[29] HATANAKA H,MOTOMURA G,IKEMURA S,et al.Differences in magnetic resonance findings between symptomatic and asymptomatic pre-collapse osteonecrosis of the femoral head[J].Eur J Radiol,2019,112:1-6.
[30] 何晓铭,龚水帝,庞凤祥,等.抵抗素水平与股骨头坏死塌陷进程的相关性[J].实用医学杂志,2019,35(4):579-583. 中医正骨2020年3月第32卷第3期 J Trad Chin Orthop Trauma,2020,Vol.32,No.3(总211) (总212)中医正骨2020年3月第32卷第3期 J Trad Chin Orthop Trauma,2020,Vol.32,No.3
[31] HE M C,GONG S D,CHEN X J,et al.Plasma C-terminal cross-linking telopeptide of type Ⅱ collagen as a biomarker in advanced stages of femoral head osteonecrosis[J].Biomed Pharmacother,2019,111:1213-1220.
[32] GONG S D,CHEN X J,CHEN Z Q,et al.Elevated plasma cartilage oligomeric matrix protein(COMP)level are associated with the progression of non-traumatic osteonecrosis of femoral head[J].Clin Chim Acta,2019,490:214-221.
[33] CHEN X J,YANG F,CHEN Z Q,et al.Association of reduced sclerostin expression with collapse process in patients with osteonecrosis of the femoral head[J].Int Orthop,2018,42(7):1675-1682.
[34] 魏秋实,何伟,张庆文,等.基于X线片建立股骨头坏死新分型体系的临床意义[J]. 中华关节外科杂志(电子版),2018,12(6):849-856.
[35] LIU T S,MA J C,SU B,et al.A 12-year follow-up study of combined treatment of post-severe acute respiratory syndrome patients with femoral head necrosis[J].Ther Clin Risk Manag,2017,13:1449-1454.
[36] WANG W, ZHANG N, GUO W, et al. Combined pharmacotherapy for osteonecrosis of the femoral head after severe acute respiratory syndrome and interstitial pneumonia:two and a half to fourteen year follow-up[J].Int Orthop,2018, 42(7):1551-1556.
[37] 何伟.精确诊断前提下股骨头坏死非手术治疗实践[J].临床外科杂志,2017,25(8):580-582.
[38] 何伟.如何把握股骨头坏死患者的保髋治疗时机[J].中国骨与关节杂志,2016,5(2):82-86.
[39] 何伟,刘予豪,周驰,等.非手术保髋治疗非创伤性股骨头坏死的临床研究[J].中国中西医结合杂志,2020,40(2):176-181.
[40] WEI Q S,HONG G J,YUAN Y J,et al.Huo Xue Tong Luo capsule,a vasoactive herbal formula prevents progression of asymptomatic osteonecrosis of femoral head:A prospective study[J].J Orthop Translat,2018,18:65-73.
[41] FANG B,LI Y,CHEN C,et al.Huo Xue Tong Luo capsule ameliorates osteonecrosis of femoral head through inhibiting lncRNA-Miat[J].J Ethnopharmacol,2019,238:111862.
[42] 中华医学会骨科学分会关节外科学组.股骨头坏死临床诊疗规范[J].中国矫形外科杂志,2016,24(1):49-54.

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备注/Memo

备注/Memo:
(收稿日期:2020-03-05 本文编辑:杨雅)通讯作者:何伟 E-mail:hw13802516062@163.com
更新日期/Last Update: 2020-03-10