基于“肾藏精、生髓”理论辨治地中海贫血的思路探析

Discussion on Syndrome Differentiation and Treatment of Thalassemia based on the Theory of“Kidney Stores Essence and Produces Marrow”

中医学“肾藏精、生髓”理论指导辨治地中海贫血已历30余年,临床检验其疗效肯定。基于理论溯源及临床中医证候调查结果,提出“肾生髓、髓生血”是中医药治疗地中海贫血的理论基础,结合“肾藏精、生髓”理论指导辨治地中海贫血的临床实践及现代分子生物学研究,认为该理论实际上分为“肾藏精”“精生髓”“髓化血”三个不同层次。通过一系列动物及临床研究从以上三个不同层次解析并验证“肾藏精、生髓”理论在指导地中海贫血治疗中的科学性,揭示了三个层次之间的区别以及联系,并使该理论的内涵在细胞、分子、信号途径、基因表达等不同层面得到总结和提炼。

It has been more than 30 years since the adoption of"kidney stores essence and produces marrow"theory in traditional Chinese medicine(TCM)in guiding syndrome differentiation and treatment of thalassemia,and the effect has been clinically approved.Through investigating the theoretical background and conducting survey on TCM syndromes,it is proposed that the theoretical basis for TCM treatment of thalassemia is rooted in the theory of"kidney produces marrow,and marrow generates blood";moreover,according to the accumulation of clinical experience and the results from the molecular biology researches,the"kidney stores essence and produces marrow"theory as guidance for thalassemia can be classified into three levels.The scientificity of this three-level theory has been analyzed and approved through a series of animal studies and clinical researches,which reveal the differences and associations among three levels,and summarize the connotations of the theory in cells,molecules,signal pathways,gene expression and other aspects.