基于“药邪致病”论治糖皮质激素性骨质疏松症

Treatment of Glucocorticoid Induced Osteoporosis Based on“Pathogenic Factors of Drugs”

从中医"药邪致病"理论,结合糖皮质激素的药性与不良反应,探讨其在糖皮质激素性骨质疏松症(glucocorticoid-induced osteoporosis,GIOP)发病及病机演变过程中的理论与实践意义,认为GIOP的发病符合糖皮质激素"药邪致病"特点,其病机演变以肾精亏虚为本,与肝、脾胃、肺等脏腑功能失常密切相关,痰浊瘀血为首要病理产物,其论治以调整阴阳、补益肾精为核心原则,同时根据不同的病程特点,兼以清燥润肺、调理脾胃、滋水涵木、涤痰通络之法,以消除药邪。中医药治疗GIOP具有独特的应用价值,值得从理论、机制、临床层面进行深入探讨。

Based on the theory of“pathogenic drug causing disease”in traditional Chinese medicine,combined with the properties and adverse reactions of glucocorticoid,the theoretical and practical significance of glucocorticoid in the pathogenesis and pathogenesis evolution of GIOP was discussed.It is considered that the pathogenesis of GIOP is in accordance with the characteristics of drug pathogenic factors.The pathogenesis of GIOP is based on deficiency of kidney essence and closely related to the dysfunction of liver,spleen,stomach and lung.Its treatment is based on the core principle of regulating Yin and Yang,tonifying kidney essence and regulating other viscera,at the same time,according to the characteristics of different course of disease,the methods of clearing dryness and moistening lung,regulating spleen and stomach,nourishing water and containing wood,clearing phlegm and dredging collaterals are used to eliminate the pathogenic drugs.The treatment of GIOP with traditional Chinese medicine has unique application value,which is worthy of in-depth discussion from the theory,mechanism and clinical level.