[1]杨博,邢涛,张应拴,等.从伏邪理论论治激素性股骨头坏死[J].中医正骨,2023,35(02):54-57.
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从伏邪理论论治激素性股骨头坏死()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第35卷
期数:
2023年02期
页码:
54-57
栏目:
学术探讨
出版日期:
2023-02-20

文章信息/Info

作者:
杨博1邢涛2张应拴1李向洲1韩李霞1钱朝良1
(1.甘肃中医药大学中医临床学院,甘肃 兰州 730000; 2.甘肃省中医院,甘肃 兰州 730050)
关键词:
股骨头坏死 邪气 温病学说 糖皮质激素 中医病机
摘要:
激素性股骨头坏死(osteonecrosis of the femoral head,ONFH)是一种致残性疾病,病因多为不规范使用糖皮质激素。伏邪理论对多种疾病的防治具有重要指导意义,且激素性ONFH的发生与伏邪致病的特点相似,但基于伏邪理论探讨激素性ONFH的报道却较为少见。本文简要介绍了伏邪理论,并从糖皮质激素不良反应的中医病机、伏邪与激素性ONFH的关系2个方面进行了理论探讨,从而总结出伏邪理论指导下激素性ONFH的防治思路。

参考文献/References:

[1] HUANG C,WEN Z,NIU J,et al.Steroid-induced osteonecrosis of the femoral head:novel insight into the roles of bone endothelial cells in pathogenesis and treatment[J/OL].Front Cell Dev Biol,2021,9:777697[2022-05-02].https://pubmed.ncbi.nlm.nih.gov/34917616/.
[2] CHANG C,GREENSPAN A,GERSHWIN M E.The pathogenesis,diagnosis and clinical manifestations of steroid-induced osteonecrosis[J/OL].J Autoimmun,2020,110:102460[2022-05-02].https://pubmed.ncbi.nlm.nih.gov/32307211/.
[3] IKEUCHI K,HASEGAWA Y,SEKI T,et al.Epidemiology of nontraumatic osteonecrosis of the femoral head in Japan[J].Mod Rheumatol,2015,25(2):278-281.
[4] FANG S,LI Y,CHEN P.Osteogenic effect of bone marrow mesenchymal stem cell-derived exosomes on steroid-induced osteonecrosis of the femoral head[J].Drug Des Devel Ther,2018,13:45-55.
[5] 朱佩轩.伏邪源流及理论发微[J].亚太传统医药,2021,17(7):194-196.
[6] 张晨晨,唐树杰.伏邪理论与运气理论[J].中华中医药杂志,2021,36(5):2597-2600.
[7] 赵明芬,安冬青,汪建萍.试论伏邪理论的源流及发展[J].中医杂志,2016,57(3):189-192.
[8] 曾治君,郑恬,吉燕华,等.伏邪理论的探讨[J].中西医结合心血管病电子杂志,2017,5(29):159-160.
[9] 吴文军,刘西洋,冯全生,等.试论伏气学说之“伏”[J].中华中医药杂志,2021,36(10):5804-5806.
[10] VANDEWALLE J,LUYPAERT A,DE BOSSCHER K,et al.Therapeutic mechanisms of glucocorticoids[J].Trends Endocrinol Metab,2018,29(1):42-54.
[11] ORAY M,ABU SAMRA K,EBRAHIMIADIB N,et al.Long-term side effects of glucocorticoids[J].Expert Opin Drug Saf,2016,15(4):457-465.
[12] 吴斌.糖皮质激素副作用的中医药研究进展[J].时珍国医国药,2010,21(3):719-721.
[13] 张金良,王宪波,曾辉.从中医学角度谈糖皮质激素副作用的药理机制[J].北京中医药,2010,29(4):276-279.
[14] 刘芬芬,羊维,黄琳,等.中医学对糖皮质激素主治功效的药性认识[J].中华中医药杂志,2015,30(4):1268-1270.
[15] CIMINO I,KIM H,TUNG Y C L,et al.Activation of the hypothalamic-pituitary-adrenal axis by exogenous and endogenous GDF15[J/OL].Proc Natl Acad Sci U S A,2021,118(27):e2106868118[2022-05-02].https://pubmed.ncbi.nlm.nih.gov/34187898/.
[16] ALTEN R,WIEBE E.Hypothalamic-pituitary-adrenal axis function in patients with rheumatoid arthritis treated with different glucocorticoid approaches[J].Neuroimmunomodulation,2015,22(1-2):83-88.
[17] XU T T,JIN H T,TONG P J.Essence of“shen(kidney)controlling bones”:conceptual analysis based on hypothalamic-pituitary-adrenal-osteo-related cells axis[J].Chin J Integr Med,2018,24(11):806-808.
[18] 曾思敏,梁琪,韦静,等.黄贵华从中医学角度论治糖皮质激素不良反应[J].上海中医药杂志,2019,53(7):18-20.
[19] 徐宇,黄维琛,郭礼跃,等.补肾运脾方对糖皮质激素性骨质疏松斑马鱼模型骨代谢的调节作用[J].中药药理与临床,2019,35(3):138-141.
[20] 温成平,谢志军.激素不同使用阶段的中医证候诊断和治疗指南[J].中华中医药杂志,2020,35(9):4536-4540.
[21] 尚奇,任辉,沈耿杨,等.基于肾阴阳理论探讨自噬在激素性骨质疏松症中的作用[J].中华中医药杂志,2018,33(8):3300-3303.
[22] LANE N E.Glucocorticoid-induced osteoporosis:new insights into the pathophysiology and treatments[J].Curr Osteoporos Rep,2019,17(1):1-7.
[23] WEINSTEIN R S.Glucocorticoids,osteocytes,and skeletal fragility:the role of bone vascularity[J].Bone,2010,46(3):564-570.
[24] SCHERHOLZ M L,SCHLESINGER N,ANDROULAKIS I P.Chronopharmacology of glucocorticoids[J].Adv Drug Deliv Rev,2019,151-152:245-261.
[25] RODRIGUEZ J M,MONSALVES-ALVAREZ M,HENRIQUEZ S,et al.Glucocorticoid resistance in chronic diseases[J].Steroids,2016,115:182-192.
[26] 冯炯,周东海,臧敏,等.从伏邪学说论治系统性红斑狼疮[J].中华中医药杂志,2019,34(10):4659-4661.
[27] TAN B,LI W,ZENG P,et al.Epidemiological study based on china osteonecrosis of the femoral head database[J].Orthop Surg,2021,13(1):153-160.
[28] WANG A,REN M,WANG J.The pathogenesis of steroid-induced osteonecrosis of the femoral head:a systematic review of the literature[J].Gene,2018,671:103-109.
[29] ZHAO Z,ZHANG L,KANG X,et al.Association between genetic polymorphisms of CR2 gene and the risk of steroid-induced osteonecrosis of the femoral head in the Chinese Han male population[J].Genet Test Mol Biomarkers,2020,24(8):460-466.
[30] GUERADO E,CASO E.The physiopathology of avascular necrosis of the femoral head:an update[J].Injury,2016,47 Suppl 6:S16-S26.
[31] NICKOLAS T L,JAMAL S A.Bone kidney interactions[J].Rev Endocr Metab Disord,2015,16(2):157-163.
[32] 李坤宁,张庆祥,徐成岩,等.伏邪病因病机特点的探析[J].中国中医急症,2019,28(12):2170-2173.
[33] 张应拴,邢涛,李盛华,等.名中医治疗股骨头坏死的用药规律分析[J].中医正骨,2021,33(9):73-75.
[34] 袁雪超,路玉峰,鲁超,等.龙元通络生骨颗粒治疗早期激素性股骨头坏死40例[J].中国中医骨伤科杂志,2021,29(3):70-74.
[35] 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.
[36] 于潼,谢利民,张振南,等.股骨头坏死中医体质分布研究[J].中国中西医结合杂志,2016,36(6):659-662.
[37] 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.
[38] 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(3):48-51.
(收稿日期:2022-05-03 本文编辑:郭毅曼)

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备注/Memo

备注/Memo:
基金项目:甘肃省科技计划项目(22JR5RA628) 通讯作者:邢涛 E-mail:xingtao1979@126.com
更新日期/Last Update: 1900-01-01