从免疫炎症机制解读骨质疏松症中医“肾气热”理论

Explanation of the Traditional Chinese Medicine“Kidney Qi Heat”Theory of Osteoporosis from the Perspective of Immune Inflammatory Mechanism

“肾气热”是《内经》论述“骨痿”的重要理论。通过对“肾气热”理论源流的考究及其临床应用的梳理,可知“肾气热”对骨质疏松症的治疗具有确切的物质基础和对应的微观调控机制。结合现代骨质疏松症炎症免疫发病机制,从微观角度探讨肾气热理论与免疫炎症发病机制的相关性,提出“肾气热”当属“阴火”,病理性质为“肾虚、肾热”,肾虚是骨质疏松症发生免疫炎症的基础,肾热是微观下骨质疏松症发生免疫炎症反应。骨质疏松症免疫炎症反应与“肾热—精亏—髓空—骨枯”病机观具有共同的演变格局,且补肾药物可从恢复炎症免疫平衡治疗骨质疏松症。从科学的视野解读“肾气热”理论,为骨质疏松症的治疗以及机制研究提供新的研究思路及科学依据。

“Kidney Qi heat”is an important theory in Inner Canon of Huangdi“Guwei”.Through the study of the theoretical origin of“kidney Qi heat”and its application in clinical practice,it can be seen that“kidney Qi heat”has a definite material basis and corresponding micro-control mechanism for the treatment of osteoporosis.Combined with the inflammatory immune pathogenesis of modern osteoporosis,this paper discusses the correlation between the theory of kidney Qi heat and the pathogenesis of immune inflammation from a micro perspective,and puts forward that“kidney Qi heat”belongs to“Yin fire”,and the pathological nature is“kidney deficiency and kidney heat”.Kidney deficiency is the basis of immune inflammation in osteoporosis,and kidney heat is the immune inflammatory reaction of osteoporosis under the microscopic view.The immune inflammatory response of osteoporosis has a common evolution pattern with the pathogenesis of“kidney heat-essence deficiency-marrow empty-bone withered”,and kidney tonifying drugs can treat osteoporosis by restoring the inflammatory immune balance.Interpreting the theory o“f kidney Qi heat”from a scientific perspective,and provide new research ideas and scientific basis for the treatment and mechanism of osteoporosis.