黄芪桂枝五物汤在骨伤科中的应用

Application of Huangqi Guizhi Wuwu Decoction in Orthopaedics and Traumatology

黄芪桂枝五物汤由黄芪、芍药、桂枝、生姜、大枣配伍组合而成,具有抗炎镇痛、抗氧化、抗肿瘤、降脂、调节免疫力等多种药理活性,在颈椎病、肩周炎、腰椎间盘突出症、膝骨关节炎、类风湿关节炎、肌筋膜疼痛综合征等骨伤科疾病的治疗中具有一定优势,临床疗效突出、药物副作用少、患者依从性高。但目前对于黄芪桂枝五物汤全方的现代药理研究不足,治疗靶点尚不明确,缺乏统一共识,亟待深入研究和挖掘,且该方并非能够治疗所有的骨伤科疾病,故临证时要始终坚持中医四诊思维,辨证选方,紧扣病机,推陈出新,扩大其适用范围,将该方在骨伤科中的应用优势体现出来,提高临床总有效率。

The Huangqi Guizhi Wuwu Decoction(HQGZWWT)is composed of Huangqi(Astragali Radix),Shaoyao(Paeoniae Radix Alba),Guizhi(Cinnamomi Ramulus),Shengjiang(Zingiberis Rhizoma Recens),and Dazao(Jujubae Fructus)which has various pharmacological anti-inflammatory,analgesic,antioxidant,antitumor,lipid-lowering,and immunity-regulating activities.It has certain advantages in the treatment of orthopaedic diseases,such as cervical spondylosis,scapulohumeral periarthritis,lumbar disc herniation,knee osteoarthritis,rheumatoid arthritis,myofascial pain syndrome,etc.,with outstanding clinical efficacy,few adverse reactions,and high patient compliance.However,modern pharmacological researches on the whole prescription of HQGZWWT are insufficient and the therapeutic targets are not clear which needs further exploration.Besides,this prescription cannot treat ll orthopaedic diseases,so we should adhere to the thinking of four diagnostics in traditional Chinese medicine(TCM),select prescriptions based on syndrome differentiation,closely follow the pathogenesis,innovate and expand its scope of application,reflect the application advantages of this prescription in orthopaedics and traumatology and improve the total clinical efficiency.