基于钙沉积异常探讨原发性骨质疏松症“痰邪”的理论研究

The theoretical study of phlegm in the primary osteoporosis based on the abnormal calcium deposition

骨质疏松症是以骨强度下降、骨折风险性增加为特征的骨骼系统疾病。与骨骼强度相关的因素主要包括骨矿密度和骨质量,骨矿化是骨代谢的重要过程,而钙的异常沉积是骨矿化异常的表现,是骨质疏松症发病及加重的因素之一。多种骨基质蛋白参与血管钙化等异位钙化的过程,研究发现治疗骨质疏松症的药物也能同时改善血管钙化,因此骨质疏松症的治疗可以从调节钙的沉积入手,通过对骨钙相关蛋白的调节,促进正常的骨矿化而抑制异位钙化,从而达到治疗骨质疏松症的目的。向楠教授领导的课题组在前期的研究中,基于对脂代谢紊乱与骨质疏松症的相关性的认识及痰浊在骨质疏松症发病中作用的认识,提出了"脂代谢异常可能与骨质疏松症痰浊有关"的假说,并制定了补肾化痰的新治则,进行了一系列的实验研究,表明了从"痰"论治骨质疏松症的可行性。现在,根据正常的钙代谢在人体内环境的调节作用及钙的异常沉积引起的病理表现,认为钙的异常沉积亦属于中医"痰邪"的范畴,因此从"痰"论治骨质疏松症还可从调节钙沉积的角度入手,运用补肾化痰法调节钙的沉积,从而达到治疗骨质疏松症的目的,这还有待进一步的研究与证实。

Osteoporosis is defined as a skeletal disease characterized by decrease of bone strength and increase of fracture risk.Bone mineral density and bone mass are the main factors related to bone strength. Bone mineralization is an important process of bone metabolism,and the abnormal deposition of calcium is one of the factors of osteoporosis. Many proteins are involved in the blood vessel calcification and abnormal deposition of calcium. It has been found that anti-osteoporosis drugs can relieve blood vessel calcification. Therefore,the treatment of osteoporosis can start from the regulation of calcium deposition by regulating bone calcium related proteins,and promote the normal bone mineralization and inhibit ectopic calcification. The hypothesis that osteoporosis may be related to abnormal lipid metabolism is proposed by the research group of Professor Xiang Nan,based on the correlation between lipid metabolic disorder and osteoporosis and the role of phlegm in the pathogenesis of osteoporosis. A newtherapeutic formula is also proposed. A series of experimental studies have been carried out and demonstrated the feasibility of treating osteoporosis from dissipating phlegm. According to the normal regulation of calcium metabolism and pathological appearance of the abnormal calcium deposition,we believe that the abnormal deposition of calcium is a category of phlegm in Chinese traditional medicine. Therefore,nourishing the kidney and dissipating phlegm formula can be used to treat osteoporosis from the regulation of calcium deposition. It needs to be further studied and confirmed.