从“骨肉不相亲”理论探讨益骨汤治疗骨质疏松症

Investigation of Yigu Decoction for Osteoporosis from the Theory of “Disharmony Between Bone and Muscle”

[目的]探讨益骨汤治疗骨质疏松症与“骨肉不相亲”理论之间的关系。[方法]通过临床跟师、临证记录及参阅文献,对“骨肉不相亲”相关理论进行归纳总结,并结合益骨汤防治骨质疏松症的基础与临床研究,探讨益骨汤与“骨肉不相亲”理论之间的联系。[结果]姚新苗教授认为,骨质疏松症的发病机制为“亏瘀致痿”,据此提出“补肾活血法”,并创制“益骨汤”治疗骨质疏松症。“骨肉不相亲”理论则揭示“骨痿”的发病机制为“土胜水”,由此进一步提出“骨痿者生于大热”,并据此提出“治痿独取阳明”治疗痿证。“亏瘀致痿”理论是“骨肉不相亲”理论的继承创新,“补肾活血法”是“治痿独取阳明”理论的传承发展。在该指导思想下创制的骨质疏松症经验方益骨汤,经过基础和临床研究证实,能够补肾壮骨、健脾活血,从多方面改善骨质疏松症。[结论]益骨汤从“骨肉不相亲”理论治疗骨质疏松症,理论可行,证据充实,为该病的预防和治疗提供了一定的思路。

[Objective] To explore the relationship between Yigu Decoction in the treatment of osteoporosis and the theory of “disharmony between bone and muscle”. [Methods] Through clinical follow-up, clinical records and references, this paper summarizes the relevant theories of “disharmony between bone and muscle”, and discusses the relationship between Yigu Decoction and “disharmony between bone and muscle” theory in combination with the basic and clinical research of Yigu Decoction in the prevention and treatment of osteoporosis. [Results] Professor YAO Xinmiao believes that the pathogenesis of osteoporosis is “flaccidity caused by deficiency and stasis”. Therefore, he puts forward the method of “tonifying the kidney and invigorating blood circulation” and creates Yigu Decoction to treat osteoporosis. The theory of “disharmony between bone and muscle” reveals that the pathogenesis of “bone impotence” is “earth restricts water”, which further puts forward that “bone impotence is born in great heat”, and accordingly puts forward “treating impotence only takes Yangming” for treating impotence syndrome. The theory of “flaccidity caused by deficiency and stasis” is the inheritance and innovation of the theory of “disharmony between bone and muscle”. The method of “tonifying the kidney and invigorating blood circulation” is the inheritance and development of the theory of “treating impotence only takes Yangming”. Under this guiding ideology, Yigu Decoction, an empirical prescription for osteoporosis, was created. It was confirmed by basic and clinical research that Yigu Decoction can tonify the kidney, strengthen the bone, strengthen the spleen and invigorate blood circulation, and improve osteoporosis in many ways. [Conclusion] Yigu Decoction treats osteoporosis from the theory of “disharmony between bone and muscle” is feasible in theory and the evidence is abundant, which provides some ideas for the prevention and treatment of the disease.