基于“虚气留滞”探讨股骨头坏死发病机制

Discussion on the Pathogenesis of Femoral Head Necrosis Based on "Deficiency-Qi Stagnation"

元气亏虚(虚气)是股骨头坏死发生与发展的内在病理基础,气滞血瘀、痰凝毒聚(留滞)是发病的关键环节,故该病的病机特点是"虚气留滞"。该病以本虚标实为主,"虚气"是内在基础,脾虚为要,肝肾亏虚为本;"留滞"是病机关键,为发病之标。因虚而留滞,或因久留滞而虚,虚气与留滞相互影响,最终邪胜正衰,发为该病。在治疗过程中,应遵循"补虚培元、开郁通滞"的原则。临床选方用药时,要抓住主次,适当兼顾,才能更加准确地辨证论治股骨头坏死。

Deficiency of Yuan Qi(deficiency qi) is the internal pathological basis of the occurrence and development of femoral head necrosis.Qi stagnation and blood stasis, phlegm coagulation and toxin accumulation(stagnation) are the key links of the disease, so the pathogenesis of the disease is characterized by " deficiency-qi stagnation ".The disease is mainly based on deficiency in origin and excess in superficiality. "Deficiency qi" is the internal basis, spleen deficiency is the main cause, and deficiency of liver and kidney is the root cause. "Stagnation" is the key of pathogenesis and the superficiality cause of its onset.Stagnation is caused by deficiency, or deficiency is caused by long-term stagnation.Deficiency Qi and stagnation interact, and pathogenic qi prevails over vital qi eventually, resulting in the disease.In the process of treatment, the principle of " reinforcing deficiency to replenish Yuanqi, expelling depression and removing stagnation" should be followed.When selecting clinical prescriptions and medicine, we should grasp the primary and secondary and give due consideration to them, so as to treat femoral head necrosis more accurately according to syndrome differentiation.