维生素D与骨性关节炎中医辨证分型相关性分析

Correlation analysis of TCM syndrome differentiation of vitamin D and osteoarthritis

目的:探讨维生素D与骨性关节炎(Osteoarthritis,OA)中医辨证分型相关性。方法:文献参考结合临床资料分析,从OA临床症状、中医辨证分型依据,维生素D功能及维生素D缺乏与OA关系等分析维生素D与OA中医辨证分型相关性。结果:维生素D作为"肾藏精"精微物质之一,与OA之间存在相关性。(1)从中医辨证分型来看:OA属于"本虚标实"的疾病之一,"肾藏精、主骨"功能下降贯穿于OA发展始末,OA中医临床辨证各型其实质是"肾藏精"功能下降的体现。(2)从既往文献研究来看:维生素D与中医"肾藏精"功能存在诸多契合点,被认为是"肾藏精"精微物质之一,其缺乏与"肾藏精、主骨"功能下降有关,从而可能影响OA进程。(3)从临床实际来看:维生素D缺乏患者更易罹患OA;补充维生素D对治疗OA具有积极意义;维生素D缺乏程度与OA临床表现具有直接联系。临床资料表明OA疼痛、肌肉力量、骨密度、影像学资料乃至严重程度评级等均与维生素D缺乏密切相关,是影响OA的重要因素之一。结论:维生素D与OA中医辨证分型存在相关性。维生素D作为"肾藏精"功能的物质基础参与了OA进程,或可成为OA中医辨证分型的潜在指标之一。

Objective: To explore the correlation between vitamin D and TCM syndrome differentiation of OA. Methods: Correlation analysis was made combined with literature reference with clinical data from the the relationship between clinical symptoms of OA, TCM syndrome differentiation evidence, the function and the lack of vitamin D and OA, with a prospect of finding out the correlation between vitamin D and TCM syndrome differentiation of OA. Results: Vitamin D had a correlation with OA as one of the subtle substances of " kidney storing essence ".(1) From the classification of TCM syndrome differentiation, OA belonged to one of the diseases of "deficiency in reality with pseudo-excess symptoms", the function of "kidney storing essence and governing bones" failed through the development of OA, and the essence of OA clinical syndrome differentiation in TCM was the decline of "kidney storing essence" function.(2) From the viewpoint of the past literature research, vitamin D was considered as one of the subtle substances of "kidney essence" in TCM derived from the numerous similar functions, and its lack was related to the decline of "kidney storing essence and governing bones" function, which may affect the OA process.(3) Clinical practice pointed out that, vitamin D deficiency was a risk factor in developing into OA; Vitamin D supplementation had positive significance for the treatment of OA. The degree of vitamin D deficiency had direct relationship with the clinical manifestation of OA. Clinical data showed that OA pain, muscle strength, bone mineral density, imaging data and even severity rating were closely related to the lack of vitamin D, therefore, vitamin D was one of the important factors affecting OA. Conclusion: There was correlation between vitamin D and TCM syndrome differentiation of OA. Vitamin D, as the material basis of "kidney storing essence", participated in the OA process, or might become one of the potential indicators of the TCM syndrome differentiation of OA.