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| 中医“肾虚髓枯”理论介导“下丘脑-垂体-肾上腺轴”在PMOP治疗中的应用进展 |
| Progress of the application of the hypothalamus-pituitary-adrenal axis in the treatment of postmenopausal osteoporosis based on the kidney deficiency and pulp depletion theory |
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| DOI：10.3969/j.issn.1006-7108.2023.11.011 |
| 中文关键词: 绝经后骨质疏松症 “肾虚髓枯”“下丘脑-垂体-肾上腺轴” 补肾益髓法 中医中药 |
| 英文关键词:postmenopausal osteoporosis kidney deficiency and marrow depletion hypothalamus-pituitary-adrenal cortex axis tonifying kidney and nourishing marrow traditional Chinese medicine |
| 基金项目:国家自然科学基金项目（82260941，81760873）；张晓刚全国名老中医专家传承工作室建设项目（国中医药人教函2022-75） |
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| 中文摘要: |
| 绝经后骨质疏松症是目前临床上的常见病，但其发病机制较为复杂，中医学“肾主骨”“脑为髓海”，“肾满髓充”是维持骨生长发育和骨代谢平衡的生物学基础，反之，“肾虚髓枯”则是绝经后骨质疏松症发病的潜在核心。随着现代医学对骨质疏松症发病本质及相关危险因素的认识不断深入，发现“下丘脑-垂体-肾上腺轴”的衰退和功能紊乱与内分泌代谢、骨微观免疫等关系密切，是绝经后骨质疏松症发病的重要生物学代谢轴。因此，将中医学“肾虚髓枯”理论与脑肾代谢轴进行靶向位点结合研究，明确两者之间的发病关联性及信号互通互调效应，并通过补肾益髓法进行生物学干预效应，具有较高的研究价值和临床意义。该综述主要以上述思路为基点，明确绝经后骨质疏松症的发病机制，以进一步指导临床。 |
| 英文摘要: |
| Postmenopausal osteoporosis is a common clinical disease at present, but its pathogenesis is relatively complex. In traditional Chinese medicine, kidney domination of bone, brain as a sea of marrow, and kidney full of marrow are the biological basis for maintaining bone growth and development and bone metabolism balance. Kidney deficiency and marrow depletion are the potential core of postmenopausal osteoporosis. With the in depth understanding of the pathogenesis of osteoporosis and related risk factors in modern medicine, it has been found that the decline and dysfunction of the hypothalamus-pituitary-adrenal axis is closely related to endocrine metabolism and bone micro-immunity, and is an important biological metabolic axis in the pathogenesis of postmenopausal osteoporosis. Therefore, it is of high research value and clinical significance to combine the theory of kidney deficiency and marrow depletion in traditional Chinese medicine with the metabolic axis of brain and kidney to study the targeted sites, to identify the pathogenesis correlation and signal intermodulation effect between them, and to conduct biological intervention effect through the method of tonifying kidney and marrow. This review is to clarify the pathogenesis of postmenopausal osteoporosis mainly based on the above ideas for further clinical guidance. |
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