基于“肝主筋,肾主骨”理论探讨股骨头坏死

Treatment of Necrosis of Femoral Head Based on"Liver Governing Tendon and Kidney Governing Bone"Theory

基于“肝主筋,肾主骨”理论,股骨头坏死的基本病机为肝血不足,筋脉失养;肾精亏虚,骨骼失充;肝肾两亏,筋骨失濡。肝藏血,血养筋,肝血不足,筋脉失养,筋的功能失常,进而导致筋骨的病变。肾封藏失司,致精亏髓减,无法濡养骨骼,骨髓失养则无力痿弱。临证应用鸡血藤、川芎、桃仁、红花、白芍等养肝补血,柔筋通络;熟地黄、何首乌、牛膝、续断、淫羊藿等补肾填精,壮骨益髓;熟地黄、杜仲、菟丝子、补骨脂、枸杞子、山茱萸、肉苁蓉等肝肾同治,筋骨并举。

Based on the theory of"Liver governing tendon and Kidney governing bone",the basic pathogenesis of femoral head necrosis is Liver blood deficiency and tendon induced malnourishment of tendon and meridian,Kidney Essence deficiency induced bone weakness,or Liver and Kidneys weakness induced poor nourishment of tendon and bone.The Liver stores blood,and the blood nourishes the tendons.If the Liver blood is insufficient,the tendons and meridians suffer poor nourishment.The tendons′dysfunction leads to the lesions of the tendons and bones.The Kidney′s dysfunction results in Essence deficiency and marrow loss,which cannot nourish the bones,and the dystrophy of bone and marrow leads to weakness of the bones.In clinical practice,drugs such as Jixueteng(Caulis spatholobi),Chuanxiong(Ligusticum wallichii),Taoren(Peach kernel),Honghua(Safflower)and Baishao(radix paeoniae alba)to nourish Liver blood,soften tendons and dredge circulation.Drugs such as Shoudihuang(Prepared rehmannia root),Heshouwu(Polygonum multiflori),Niuxi(Radix achyranthis bidentatae),Xuduan(Radix dipsaci)and Yinyanghuo(Epimedium)are used to tonify Kidney,increase Essence,strengthen bones and benefit marrow.Shoudihuang()Rehmannia rehmannia,Duzhong(Eucommia),Tusizi(Dodder seed),Buguzhi(Fructus psoraleae),Gouqizi(Wolfberry),Shanzhuyu(Dogwood),Roucongrong(Cistanche)are used to treat Liver and Kidney at the same time,with tendons and bones being nourished simultaneously.