基于“五脏偏倾”理论探析青少年特发性脊柱侧弯中医病机与治则

Analysis of Pathogenesis and Treatment Principles of Adolescent Idiopathic Scoliosis Based on Theory of“Five Viscera Deviation”

[目的]探析青少年特发性脊柱侧弯中医病机与治则,开拓其中医诊治思路。[方法]通过查阅中医古代文献中青少年特发性脊柱侧弯相关文献,基于《黄帝内经》“五脏偏倾”理论,通过文献研究总结青少年特发性脊柱侧弯中医病因、病机、治则治法,探讨中医“五脏偏倾”理论对AIS治疗与调摄的指导作用。[结果]文献研究发现,《黄帝内经》“五脏偏倾”表现与青少年特发性脊柱侧弯的病变部位、症状特征高度一致。基于中医“五脏偏倾”理论的学术内涵,青少年特发性脊柱侧弯症因以禀赋不足为主,饮食不节、劳倦所伤为诱,病机以脾肾失调、五脏偏倾为本,筋出槽、骨错缝为标,治则为调理脾肾、端正五脏、筋骨并重、内外结合,治法应综合内服、外治、导引、食疗等多种方法。[结论]青少年特发性脊柱侧弯与“五脏偏倾”高度相关。基于“五脏偏倾”理论探讨青少年特发性脊柱侧弯的病机与治则,可以为青少年特发性脊柱侧弯的“治未病”“既病防变”临床诊疗提供中医思路,值得重视与进一步挖掘并应用于临床。

[Objective]To analyze the pathogenesis and treatment of adolescent idiopathic scoliosis(AIS)in traditional Chinese medicine based on the theory of“five viscera deviation”,and develop the idea of its diagnosis and treatment in traditional Chinese medicine.[Methods]By reviewing the ancient Chinese medicine literature related to AIS,and based on the theory of“five viscera deviation”in Huangdi Neijing,this research summarized the etiology,pathogenesis and therapeutic rules of Chinese medicine in AIS through the literature study,and explored the guiding role of Chinese medicine theory of“five viscera deviation”for the treatment and regimen of AIS.[Results]Literature research has found that the performance of the“five viscera deviation”in Huangdi Neijing is highly consistent with the lesion site and symptom characteristics of AIS.Based on the academic connotation of the theory of“five viscera deviation”in Chinese medicine,the etiology of AIS is based on endowment insufficiency,with dietary disorders and injuries caused by fatigue as the triggers,and the mechanism of the disease is based on the disorders of the spleen and kidney and the five viscera deviation,with the tendons out of the grooves and the bones out of joints as the symptoms,and the treatment should be based on the principle of adjusting the spleen and kidney,rectifying the five viscera,and emphasizing on both the tendons and the bones and the combination of internal and external treatments.The treatment should be a combination of internal medicine,external treatment,guiding and dietary therapy.[Conclusion]AIS is highly related to“five viscera deviation”.Based on the theory of“five viscera deviation”,it discusses the disease mechanism and treatment rules of AIS,which can provide Chinese medicine ideas for the clinical diagnosis and treatment of AIS,and worthy of attention,further exploration and clinical application.