补阳还五汤治疗中医骨伤科疾病研究进展

Research Progress of Yang-Supplementing and Five-Returning Decoction in Treating Orthopedic and Traumatology Diseases of TCM

补阳还五汤在中医骨伤科中应用广泛,主要用于颈椎病、腰椎间盘突出症、腰椎椎管狭窄症、膝关节骨性关节炎、腕管综合征、下肢深静脉血栓、糖尿病足、强直性脊柱炎等疾病的治疗中。查阅文献及结合临床实践发现,补阳还五汤的剂量及药味变化频次较多,究其原因可能有:(1)目前临床证型与古书记载时有变化,单用原方而不加减变化可能影响疗效;(2)部分医家经验随证临床加减,可通过对当代中医大家临床经验总结,进行系统归纳学习;(3)当今药材质量不如从前,按原方记载之含量可能达不到理想治疗效果,这也提示在临床治疗中,不可拘泥于古书记载,要根据临床情况加减变化药物及药量。目前,本方虽已在临床上广泛使用,但在用药过程中仍需谨慎,对于大剂量黄芪的使用需警惕肝肾功能的损害。本方临床疗效甚佳,但在治疗如腰椎椎管狭窄症等疾病时,仍然缺乏作用机制的研究,后续研究可针对作用机制展开重点实验,为进一步临床使用提供切实有效的实验数据。

Yang-Supplementing and Five-Returning Decoction is widely used in orthopedics and traumatology of TCM.It is mainly adopted in the treatment of cervical spondylosis,lumbar disc herniation,lumbar spinal stenosis,knee osteoarthritis,carpal tunnel syndrome,deep vein thrombosis of lower extremity,diabetes foot,ankylosing spondylitis and other diseases.According to literature review and clinical practice,it is found that the dose and taste of Yang-Supplementing and Five-Returning Decoction change frequently.The reasons may be as follows:(1) At present,there are changes in clinical syndrome types and ancient records,and only using the original formula without adding or subtracting changes may affect the curative effect;(2) Some doctors′ experiences can be added or subtracted according to the clinical evidence,which can be systematically summarized and learned by summarizing the clinical experience of great contemporary Chinese medicine practitioners;(3) Nowadays,the quality of medicinal materials is relatively poor,and the content recorded in the original formula can not achieve the desired therapeutic effect,which also suggests that in clinical treatment,it is not necessary to adhere to the records in ancient books,but it is needed to add or subtract drugs and dose according to exact clinical conditions.At present,although Yang-Supplementing and Five-Returning Decoction has been widely used in clinical practice,people still need to be cautious in the course of medication.For the use of large dose of Huangqi(Radix Scutellariae),it is necessary to be alert to the damage of liver and kidney functions.The clinical effect of this formula is very good,but in the treatment of diseases such as lumbar spinal stenosis,there is still a lack of research on the mechanism of action.Therefore,the follow-up research can focus on the mechanism of action to provide practical and effective experimental data for further clinical application.