Integrative analysis of bone-formation associated genes and immune cell infiltration in osteoporosis, and the prediction of active ingredients in targeted traditional Chinese medicine

Objective To explore the differential expression and mechanisms of bone formation-related genes in osteoporosis(OP)leveraging bioinformatics and machine learning methodologies;and to predict the active ingredients of targeted traditional Chinese medicine(TCM)herbs.Methods The Gene Expression Omnibus(GEO)and GeneCards databases were employed to conduct a comprehensive screening of genes and disease-associated loci pertinent to the pathogenesis of OP.The R package was utilized as the analytical tool for the identification of differentially expressed genes.Least absolute shrinkage and selection operator(LASSO)logis-tic regression analysis and support vector machine-recursive feature elimination(SVM-RFE)algorithm were employed in defining the genetic signature specific to OP.Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analyses for the selected pivotal genes were conducted.The cell-type identification by estimating rela-tive subsets of RNA transcripts(CIBERSORT)algorithm was leveraged to examine the infiltra-tion patterns of immune cells;with Spearman’s rank correlation analysis utilized to assess the relationship between the expression levels of the genes and the presence of immune cells.Coremine Medical Database was used to screen out potential TCM herbs for the treatment of OP.Comparative Toxicogenomics Database(CTD)was employed for forecasting the TCM ac-tive ingredients targeting the key genes.AutoDock Vina 1.2.2 and GROMACS 2020 softwares were employed to conclude analysis results;facilitating the exploration of binding affinity and conformational dynamics between the TCM active ingredients and their biological targets.Results Ten genes were identified by intersecting the results from the GEO and GeneCards databases.Through the application of LASSO regression and SVM-RFE algorithm;four piv-otal genes were selected:coat protein(CP);kallikrein 3(KLK3);polymeraseγ(POLG);and transient receptor potential vanilloid 4(TRPV4).GO and KEGG pathway enrichment analy-ses revealed that these trait genes were predominantly engaged in the regulation of defense response activation;maintenance of cellular metal ion balance;and the production of chemokine ligand 5.These genes were notably associated with signaling pathways such as ferroptosis;porphyrin metabolism;and base excision repair.Immune infiltration analysis showed that key genes were highly correlated with immune cells.Macrophage M0;M1;M2;and resting dendritic cell were significantly different between groups;and there were signifi-cant differences between different groups(P<0.05).The interaction counts of resveratrol;curcumin;and quercetin with KLK3 were 7;3;and 2;respectively.It shows that the interac-tions of resveratrol;curcumin;and quercetin with KLK3 were substantial.Molecular docking and molecular dynamics simulations further confirmed the robust binding affinity of these bioactive compounds to the target genes.Conclusion Pivotal genes including CP;KLK3;POLG;and TRPV4;exhibited commendable significant prognostic value;and played a crucial role in the diagnostic assessment of OP.Resveratrol;curcumin;and quercetin;natural compounds found in TCM;showed promise in their potential to effectively modulate the bone-forming gene KLK3.This study provides a sci-entific basis for the interpretation of the pathogenesis of OP and the development of clinical drugs.

Effect of traditional Chinese medicine on rheumatoid arthritis bone destruction:A systematic review and meta-analysis

Objective:To systematically evaluate the efficacy of Traditional Chinese medicine for improving bone damage in rheumatoid arthritis(RA),and provide guidance for clinical treatment.Methods:computer retrieval China hownet database(CNKI),Chinese biomedical literature retrieval(SinoMed),ten thousand Data knowledge service system(WanFang Data),VIP full-text database(VIP),PubMed,MedLine and the cochrane library,collect relevant Chinese medicine for the treatment of rheumatoid arthritis,bone destruction randomized controlled trial(RCT),screening from built by researchers at the two libraries to literature in February 2020,to extract the required indicators,and incorporated into RevMan 5.2 analysis.Results:a total of 1291 patients were included in 14 RCTS.The results of meta-analysis showed that compared with the control group,The traditional Chinese medicine treatment group could improve the 25-hydroxyvitamin D of patients with RA bone damage,which was better than the western medicine control group,and the difference was statistically significant.TCM treatment group can improve the balance between osteoblasts and osteoclasts(nuclear factor B receptor activating factor;Bone mineral density;Bone alkaline phosphatase;Bone protectin;(osteocalcin),and was superior to the western medicine control group,the difference was statistically significant;(3)traditional Chinese medicine treatment group can improve RA patients with bone destruction of the balance of osteoblast and osteoclast(Ⅰtype collagen amino terminal propeptide before;Carboxy-terminal peptide of collagen;The effect of nuclear factor B receptor activator factor and bone protectin was similar to that of the western medicine control group,and the difference was not statistically significant.Conclusion:At present,the existing evidence can prove that Traditional Chinese Medicine in the treatment of rheumatoid arthritis bone damage has an exact effect,regulate the function of osteoblasts and osteoclasts,improve the level of bone metabolism of patients,prevent the progress of bone damage.

The mechanism and traditional Chinese medicine research of bone destruction and hypercalcemia in multiple myeloma

Multiple myeloma is a malignant proliferative disease of plasma cells. Its main feature is the malignant proliferation of monoclonal plasma cells and the secretion of a large number of monoclonal immunoglobulins. Because of the uncontrolled proliferation, extensive infiltration of malignant plasma cells, and the appearance and deposition of a large number of monoclonal immunoglobulins, normal polyclonal plasma cell proliferation and polyclonal immunoglobulin secretion are inhibited. It can cause extensive bone destruction, hypercalcemia, repeated infection, renal insufficiency, high viscosity syndrome and other clinical manifestations, which can alsolead to adverse consequences.In view of these unique clinical manifestations and pathological features of multiple myeloma, we systematically expounded the pathological characteristics of multiple myeloma and the treatment of traditional Chinese medicine from extensive bone destruction and hypercalcemia on the basis of Chinese and Western medicine. In order to provide theoretical support and clinical guidance for the treatment of multiple bone marrow tumors with bone destruction and hypercalcemia.

Relationship of serum GDF11 levels with bone mineral density and bone turnover markers in postmenopausal Chinese women

Growth differentiation factor 11 （GDF11） is an important circulating factor that regulates aging. However, the role of GDF11 in bone metabolism remains unclear. The present study was undertaken to investigate the relationship between serum GDF11 level, bone mass, and bone turnover markers in postmenopausal Chinese women. Serum GDF11 level, bone turnover biochemical markers, and bone mineral density （BMD） were determined in 169 postmenopausal Chinese women （47-78 years old）. GDF11 serum levels increased with aging. There were negative correlations between GDF11 and BMD at the various skeletal sites. After adjusting for age and body mass index （BMI）, the correlations remained statistically significant. In the multiple linear stepwise regression analysis, age or years since menopause, BMI, GDF11, and estradiol were independent predictors of BMD. A significant negative correlation between GDF11 and bone alkaline phosphatase （BAP） was identified and remained significant after adjusting for age and BMI. No significant correlation was noted between cross-linked N-telopeptides of type I collagen （NTX） and GDF11. In conclusion, GDF11 is an independent negative predictor of BMD and correlates with a biomarker of bone formation, BAP, in postmenopausal Chinese women. GDF11 potentially exerts a negative effect on bone mass by regulating bone formation.

Bone mineral density of the spine and femur in healthy Chinese men

Aim:To establish bone mineral density(BMD)reference database in healthy Chinese men of Han ethnicity,and to estimate the prevalence of osteoporosis in the population.Methods:The BMD in the lumbar spine 1-4(L1-4)and proximal femur was measured using dual energy X-ray absorptiometry in a total of 1385 healthy Chinese men of Han ethnicity aged 20-89 years old in Shanghai.Results:The highly significant negative correlation between age and BMD at any sites of proximal femur was found in the studied population,wheras no correlation between age and BMD at lumbar spine was observed.The peak BMD of the lumbar spine and any sites of hip in Chinese men was defined as the mean BMD for the subjects aged 20-39 years.According to World Health Organization(WHO)criteria,the BMD cut-off values for osteoporosis of the L1-4,total hip,femoral neck,trochanter and intertrochanter in Chinese men are 0.719,0.638,0.575,0.437 and 0.725 g/cm^2,respectively.Using the current Chinese reference data,the prevalence of osteoporosis at the L1-4,total hip,femoral neck,trochanter and intertrochanter is 5.4%,3.8%,6.3%, 1.8% and 2.8% in 1084 men aged 50 years or older,respectively.However,using a database for US non-Hispanic white men(NHANES Ⅲ),the prevalence of osteoporosis or osteopenia at any sites of the hip was significantly higher than that while using the current Chinese reference data.Conclusion:The BMD reference database was established in healthy Chinese men of Han ethnicity,and will facilitate more accurate diagnosis of osteoporosis in Chinese men. (Asian J Androl 2006 Jul;8:419-427)

Review for treatment and signaling pathway regulation of kidney-tonifying traditional Chinese medicine on osteoporosis

The treatment and signaling pathway regulation effects of kidney-tonifying traditional Chinese medicine on osteoporosis have been widely studied,but without a systematic summary currently.This review comprehensively collected and analyzed the traditional Chinese medicine on the treatment and signaling pathway regulation of osteoporosis in recent ten years,such as Epimedium,Drynariae Rhizoma,Cnidium,Eucommia,Psoralen and Dipsacus.Based on the existing findings,we concluded the following conclusions:(1)kidney-tonifying traditional Chinese medicine treats osteoporosis mainly through BMP-Smads,Wnt/β-catenin,MAPK,PI3K/AKT signaling pathway to promote osteoblast bone formation and through OPG/RANKL/RANK,estrogen,CTSK signaling pathway to inhibit osteoclasts of bone resorption.(1)Epimedium,Drynariae Rhizoma,Cnidium and Psoralen up-regulate the key proteins and genes of BMP-Smads and Wnt/β-catenin signaling pathways to promote bone formation.(2)Epimedium,Drynariae Rhizoma,Cnidium,Eucommia,Psoralen,Dipsacusinhibit the bone resorption by mediating the OPG/RANKL/RANK signaling pathway.(2)Kidney-tonifying traditional Chinese medicine prevent and treat osteoporosis through a variety of ways:Icariin,Naringin,Osthol,Psoralen can regulate BMP-Smads,Wnt/β-catenin signaling pathway to promote bone formation,but also activate OPG/RANKL/RANK,CTSK and other signaling pathway to inhibit bone resorption.(3)The crosstalk of the signaling pathways and the animal experiments of the traditional Chinese medicine on the prevention and treatment of osteoporosis as well as their multi-target mechanism and comprehensive regulation need further clarification.

Traditional Chinese medicine manipulative reduction combined with percutaneous vertebroplasty for treating type Ⅲ Kummell's disease: A case report

BACKGROUND A patient with type Ⅲ Kummell’s disease had a ruptured posterior cortex of the fractured vertebral body, which caused spinal cord compression. An open surgery was considered the best choice of operation. However, the patient and her family refused open surgery and instead demanded a minimally invasive surgical treatment such as percutaneous vertebroplasty(PVP). After preoperative discussion, we finally adopted the novel therapy of traditional Chinese medicine manipulative reduction(TCMMR) combined with PVP.CASE SUMMARY A patient with type Ⅲ Kummell’s disease exhibiting bone block-induced spinal cord compression was admitted to our hospital. She suffered from a variety of medical disorders but refused open surgery, and instead asked for PVP surgery. TCMMR, in parallel with PVP, was used to restore the height of the compressed vertebral body and reduce the symptoms of spinal cord compression by the bone block in order to strengthen the vertebral body and prevent further collapse. The surgery was very successful. The height of the compressed vertebra was restored, and the symptom of spinal cord compression by bone block was reduced successfully via TCMMR. The fractured vertebra was solidified by the PVP. The pain visual analog score declined from preoperative 7 scores to postoperative 2 scores, and the Frankel spinal cord scale increased from preoperative D degree to postoperative E degree.CONCLUSION The new method has advantages in treating patients with type Ⅲ Kummell’s disease who cannot be treated with open surgery.

Prevalence and risk factors of osteoporosis detected by dual-energy X-ray absorptiometry among Chinese patients with primary biliary cholangitis

BACKGROUND Osteoporosis is an extrahepatic complication of primary biliary cholangitis(PBC)that increases the risk of fractures and mortality.However,Epidemiological studies of osteoporosis in patients with PBC in China and the Asia-Pacific region is lack.AIM To assess the prevalence and clinical characteristics of osteoporosis in Chinese patients with PBC.METHODS This retrospective analysis included consecutive patients with PBC from a tertiary care center in China who underwent bone mineral density(BMD)assessment using dual-energy X-ray absorptiometry between January 2013 and December 2021.We defined subjects with T-scores≤-2.5 in any sites(L1 to L4,femoral neck,or total hip)as having osteoporosis.Demographic,serological,clinical,and histological data were collected.Independent risk factors for osteoporosis were identified by multivariate logistic regression analysis.RESULTS A total of 268 patients with PBC[236 women(88.1%);mean age,56.7±10.6 years;163 liver biopsies(60.8%)]were included.The overall prevalence of osteoporosis in patients with PBC was 45.5%(122/268),with the prevalence of osteoporosis in women and men being 47.0%and 34.4%,respectively.The prevalence of osteoporosis in postmenopausal women was significantly higher than that in premenopausal women(56.3%vs 21.0%,P<0.001).Osteoporosis in patients with PBC is associated with age,fatigue,menopausal status,previous steroid therapy,body mass index(BMI),splenomegaly,gastroesophageal varices,ascites,Mayo risk score,histological stage,alanine aminotransferase,albumin,bilirubin,platelet and prothrombin activity.Multivariate regression analysis identified that older age,lower BMI,previous steroid therapy,higher Mayo risk score,and advanced histological stage as the main independent risk factors for osteoporosis in PBC.CONCLUSION Osteoporosis is very common in Chinese patients with PBC,allowing for prior screening of BMD in those PBC patients with older age,lower BMI,previous steroid therapy and advanced liver disease.

In vitro bone inducing effects of Lentinula edodes (shiitake) water extract on human osteoblastic cell cultures

The effect of Lentinula edodes water extract(LE)on two osteoblastic cell cultures(HOS 58 and Saos-2)was investigated to determine if this edible medicinal mushroom has osteoinductive properties.Activity of alkaline phosphatase and mineralization were used as indicators for the vitality and maturation of the bone cells.Cultivation of human osteosarcoma cells HOS 58 for five days in presence of a serial dilution of the aqueous extract of L.edodes(0.8μg/mL-125μg/mL)resulted in a significant elevation of alkaline phosphatase activity(ALP)of the cells in comparison to untreated cells.Saos-2 cells,incubated with LE(20μg/mL)andb-glycerol phosphate(2 mM)for 21 days,displayed a 2 fold level of mineralization than cells cultured soley with the positive control,b-glycerophosphate.The obtained results clearly indicate the activity of LE as a bone inducing agent in vitro.Therefore,the shiitake mushroom(L.edodes)deserves attention as a supportive dietary treatment or nutraceutical in the case of diseases accompanied with bone disorder,such as osteoporosis,osteopenia,and late complication of diabetes.

The effects of Yishen Qutong granula on pain sensitization and bone destruction of rats with bone cancer pain

Objective:To study the effects of Yishen Qutong granula on pain sensitization and bone destruction of rats with bone cancer pain.Methods:Walker256 cells were passaged in ascites and injected into the tibia of female Wistar rats to prepare the bone cancer pain model.On the 14th day after model establishment,60 rats were randomly divided into model group,sham-operated group,Yishen Qutong granula low,middle,high dose group and tramadol hydrochloride positive control group.After continuous administration for 14 days,the mechanical pain threshold,thermal threshold and weight-bearing difference of both hind limbs were observed.Results:Compared with the model group,Yishen Qutong groups increased the mechanical pain threshold,thermal pain threshold and reduced the weight difference of both hind limbs(P<0.05).Compared with the positive drug group,there was no significant difference in increasing the mechanical pain threshold and thermal pain threshold of rats in the medium dose group of Yishen Qutong(P>0.05),and Yishen Qutong granula significantly reduced the weight-bearing difference of hind limbs in all groups(P<0.05).Conclusion:Yishen Qutong granula can relieve pain sensitization and alleviate bone damage in rats with bone cancer pain.

The prognosis and survival of integrated traditional Chinese and western medicine on glioma: a meta-analysis

Objective:To systematically access the effects of integrated traditional Chinese and western medicine treatment versus western medicine treatment alone in glioma.Methods:Published randomized controlled trials were included from electronic databases(Cochrane Library,Pubmed,Embase,Chinese National Knowledge Infrastructure,Wanfang database,Chinese Scientific Journal Database,Chinese Biomedical Literature Database.Deadline on January 30,2020).The Cochrane handbook was referred to evaluate the methodological quality.Curative efficacy,gastrointestinal side effects,bone marrow suppression,survival time and quality of life(Karnofsky)were compared between the two groups.Meta-analysis was conducted using Reveman 5.3 and Stata 14.0 software.Results:Twelve randomized controlled trials involved 886 cases were selected,including 446 cases in the trial group and 440 cases in the control group.The meta-analysis indicated that the overall efficacy of integrated traditional Chinese and western medicine showed significant improvement compared with western medicine alone.The effects included reduced tumor size(RR=1.32,95%CI(1.18,1.49),P<0.05),gastrointestinal adverse reactions(RR=0.42,95%CI(0.30,0.60),P<0.05),bone marrow suppression(RR=0.437,95%CI(0.282,0.677),P<0.05),and improved KPS score(SMD=0.632,95%CI(0.312,0.952),P<0.05).Conclusion:For patients with glioma,integrated traditional Chinese and western medicine treatment can be one of the options for a better treatment.

Review on the research of Chinese medicine promoting tissue regeneration

In the long history of the Chinese nation,traditional Chinese medicine has made great contributions to the protection of the health of the Chinese people.Given that many pathological processes can cause tissue damage,does Chinese medicine also promote tissue regeneration in the process of disease recovery?It has been found from recent research articles that traditional Chinese medicine can promote tissue regeneration in the treatment of diseases.The following is an illustration of the role of Chinese medicine in selected parts of the study.

益肾固疏方干预老年性骨质疏松症患者骨代谢标志物的变化及临床疗效

背景:随着疾病治疗模式的改变及近年来对老年性骨质疏松症研究的深入,越来越多的研究证实中医药在防治老年性骨质疏松症方面的效果显著。目的:探讨益肾固疏方对肾虚血瘀型老年性骨质疏松症患者骨代谢标志物的影响。方法:选择2020年7月至2022年3月广西中医药大学附属瑞康医院收治的肾虚血瘀型老年性骨质疏松症患者102例,其中男32例,女70例,年龄71-93岁。采用随机数字表法将102例患者分为试验组及对照组,每组51例,对照组给予碳酸钙D3颗粒+阿仑磷酸钠片治疗,治疗组给予碳酸钙D3颗粒+阿仑磷酸钠片+益肾固疏方治疗,连续治疗3个月。治疗前及治疗3个月后,检测两组患者L_(1-4)椎体与左侧股骨颈骨密度,评估目测类比评分,检测血清骨钙素、骨桥素、Ⅰ型胶原交联C-末端肽及抗酒石酸酸性磷酸酶水平,评估中医证候积分与治疗有效率。结果与结论:①两组治疗3个月后的L1-4椎体与左侧股骨颈骨密度均高于治疗前(P<0.05),试验组治疗3个月后的L1-4椎体与左侧股骨颈骨密度均高于对照组(P<0.05);②两组治疗3个月后的目测类比评分均低于治疗前(P<0.05),试验组治疗3个月后的目测类比评分低于对照组(P<0.05);③两组治疗3个月后的血清骨钙素、骨桥素、Ⅰ型胶原交联C-末端肽及抗酒石酸酸性磷酸酶水平均较治疗前明显改善(P<0.05),试验组治疗3个月后的血清骨钙素、骨桥素水平高于对照组(P<0.05),Ⅰ型胶原交联C-末端肽及抗酒石酸酸性磷酸酶水平低于对照组(P<0.05);④两组治疗3个月后的中医证候总评分均低于治疗前,试验组治疗3个月后的中医证候总评分低于对照组;治疗3个月后,两组均未发生明显不良反应,试验组于对照组治疗总有效率分别为88.2%,70.6%,组间比较差异有显著性意义(P<0.05);⑤结果显示,益肾固疏方联合抗骨质疏松药物可通过调节骨代谢、提高骨密度、减轻患者病痛来显著改善肾虚血瘀型老年性骨质疏松症患者的临床症状,阻止疾病的进一步发展。

基于筋骨理论对青少年颈痛的临床新思考

青少年颈痛症状类似于成人颈椎病,但其病理改变并不完全符合颈椎椎间盘退变。因此,应积极探索更符合其临床特点的病因学和病理学理论,实现临床对青少年颈痛的有效诊断与治疗。在石氏伤科百年治伤临床经验和最新科学研究认识的基础上,探讨青少年颈痛的诊断名称和基于“筋骨合和”理论的病因病机,并针对颈部“筋出槽、骨错缝”核心病机建立“四以相和”的诊治策略。

基于骨免疫学论中医药抑制类风湿关节炎骨破坏的研究进展

类风湿关节炎(RA)是一种以滑膜炎、软骨与骨破坏为主要病理表现的自身免疫性疾病,致残率较高。RA免疫及炎症反应与骨细胞代谢互为影响,其核心环节为破坏机体核因子κB受体活化因子配体/核因子κB受体活化因子/骨保护素(RANKL/RANK/OPG)信号通路的平衡,导致成骨细胞减少,以及破骨细胞凋亡减退及异常活化。西药目前以抑制炎症反应及相关细胞因子分泌,减缓疾病进展,但长期使用其不良反应难以忽视。中医药在防治骨破坏中研究逐步深入,但在基础及临床研究方面仍存在一定局限性。

复方中草药制剂对林下绿壳蛋乌鸡产蛋性能、蛋品质和血清生化指标的影响

本研究旨在探究日粮中添加不同水平的复方中草药制剂对林下绿壳蛋乌鸡产蛋性能、蛋品质、血清生化指标的影响。选取520日龄健康、体质量接近的绿壳蛋乌鸡560羽,随机分成4组,分别为对照组和试验Ⅰ组、Ⅱ组、Ⅲ组。对照组饲喂基础日粮,试验Ⅰ组、Ⅱ组、Ⅲ组分别在基础日粮中添加0.5%、1.0%、1.5%的复方中草药制剂,试验期45 d。结果显示,日粮中添加不同水平的复方中草药制剂对林下绿壳蛋乌鸡的平均蛋重、平均产蛋率、绿壳蛋破损率有显著影响,其中Ⅱ组平均蛋重显著高于对照组(P<0.05),Ⅰ组、Ⅱ组平均产蛋率显著高于对照组(P<0.05),Ⅱ组绿壳蛋破损率显著低于对照组(P<0.05);日粮中添加不同水平的复方中草药制剂对绿壳蛋蛋黄相对重、蛋白高度、蛋黄水分含量、蛋黄指数及哈氏单位有显著影响,其中Ⅱ组绿壳蛋蛋黄相对重显著高于对照组(P<0.05),Ⅰ组、Ⅱ组、Ⅲ组绿壳蛋蛋白高度显著高于对照组(P<0.05),Ⅱ组、Ⅲ组绿壳蛋水分含量显著低于对照组和Ⅰ组(P<0.05),Ⅱ组绿壳蛋蛋黄指数显著高于对照组、Ⅰ组、Ⅲ组(P<0.05),Ⅱ组绿壳蛋哈氏单位显著高于对照组和Ⅲ组(P<0.05);日粮中添加不同水平的复方中草药制剂对林下绿壳蛋乌鸡的血清总蛋白(TP)、球蛋白(GLO)、丙氨酸氨基转移酶(ALT)、胆固醇(TC)和甘油三酯(TG)有显著影响,其中Ⅰ组、Ⅱ组血清TP含量显著高于对照组(P<0.05),Ⅰ组、Ⅱ组、Ⅲ组血清GLO含量显著高于对照组(P<0.05),Ⅲ组血清ALT活性显著高于对照组和Ⅰ组(P<0.05),Ⅱ组血清TC和TG含量显著高于对照组(P<0.05)。综上,日粮中添加不同水平的复方中草药制剂能改善绿壳蛋乌鸡的产蛋性能、蛋品质及血清生化指标,且以1.0%添加量的复方中草药制剂效果最佳。

中医筋骨理论中筋与骨的关系内涵探讨

中医骨伤科学具有鲜明的特色,其中筋骨理论对指导临床具有重大的意义。筋骨理论是中医骨伤科学的经典理论,但筋骨理论散在记载于各经典中,筋与骨内涵关系尚未有系统的阐述,尤其是生理、病理、治疗原则上的关系均为零散阐述。本文综合文献认为筋骨理论筋与骨内涵关系主要表现在:生理上相辅相成,体现为筋骨和合、骨正筋柔、筋强骨壮、筋骨互用等;病理上相互影响,体现为筋弛骨痿、筋滞骨错、骨错筋挪、骨断筋离等;治疗上同辨同治,体现为:理筋正骨、筋骨并重、筋骨平衡、调衡筋骨、根源同治等。骨伤临床实践遵循筋骨理论的指导原则,无论内治或外治,均需要辨病辨证结合,同时“辨骨、辨筋”相结合。

中药外敷联合复合超声关节治疗仪治疗膝骨关节炎的临床效果

目的探究中药外敷联合复合超声关节治疗仪在膝骨关节炎(KOA)中的应用效果。方法选取2022年8月至2023年8月就诊于安阳市中医院的99例KOA患者为研究对象,随机分为3组,每组33例。超声组接受超声关节治疗仪治疗,中药组接受中药外敷治疗,联合组接受中药外敷联合超声关节治疗仪治疗。对比3组疗效及治疗前后西安大略和麦克马斯特大学骨关节炎指数(WOMAC)、视觉模拟评分法(VAS)、奎森功能演算(Lequesne)指数评分、成纤维细胞生长因子2(FGF-2)、Ⅰ型胶原C-末端肽(CTX-I)、软骨寡聚基质蛋白(COMP)及不良反应。结果联合组总有效率[93.94%(31/33)]高于超声组[75.76%(25/33)]、中药组[72.73%(24/33)](P<0.05),超声组与中药组总有效率对比,差异无统计学意义(P>0.05);治疗3个疗程后联合组FGF-2高于超声组、中药组,CTX-1、COMP、Lequesne、WOMAC评分低于超声组、中药组(P<0.05),超声组、中药组组间对比,差异无统计学意义(P>0.05);治疗3个疗程后联合组静态、动态VAS评分<中药组<超声组(P<0.05);治疗期间3组均未出现不良反应。结论中药外敷与复合超声关节治疗仪联合治疗KOA患者效果确切,可有效调节骨代谢指标,有助于缓解患者疼痛感,恢复膝关节功能。

基于“筋、节、骨、髓”分型探讨神经根型颈椎病的手法治疗

神经根型颈椎病(CSR)是一种由于颈椎间盘和椎间关节退变引起的疾病,主要表现为颈部、肩部及上肢神经支配区域的疼痛、感觉异常和运动障碍。传统中医的筋骨辨证在治疗该病时存在概念不清、辨证分型不一等问题。岐黄学者林定坤教授在筋骨辨证的基础上,结合现代解剖学提出了颈椎“筋”“节”“骨”“髓”4大分型。该文通过总结林定坤教授对CSR筋骨辨证学术思想,总结手法治疗该病的作用靶点,提出基于筋劳、节错、骨变和髓损等4种病损分型,采用理筋、调节、护髓和治骨4种手法治疗,以期完善骨伤科手法治疗CSR的辨证施治体系,为临床提供参考。

构建中医药防控体系对实施骨健康计划的战略意义

随着人口老龄化及社会生活方式的转变,骨伤科疾病发病率呈逐年上升趋势,已成为威胁我国人民群众生命健康的重大公共卫生问题。近年来,党的二十大报告提出“实施积极应对人口老龄化国家战略”,《“健康中国2030”规划纲要》要求“开展健康骨骼专项行动”。相关政策与规划的出台,标志着在后疫情时代发展坐标系上,适时提出并开展骨健康计划,充分挖掘中医药服务骨健康潜在价值具有重大战略意义。