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| 由“髓减骨枯”与“微骨折”探讨骨质疏松症与膝骨关节炎的共病内涵 |
| To explore the connotation of the comorbidity of osteoporosis and knee osteoarthritis based on"marrow depletion and bone depletion" and "microfracture" |
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| DOI：10.3969/j.issn.1006-7108.2024.03.014 |
| 中文关键词: 骨质疏松症 膝骨关节炎 共病管理 微骨折 异病同治 髓减骨枯 |
| 英文关键词:osteoporosis knee osteoarthritis comorbidity management microfracture different diseases with the same treatment marrow weakened bone withered |
| 基金项目:中国中医科学院科技创新工程-骨伤科学重大攻关项目（CI2021A02012）；国家中医药管理局中医药国际合作专项中心类项目（0610-2040NF020931）；中国中医科学院眼科医院高水平中医医院“领军人才”项目立项项目（GSP5-81）；中国中医科学院眼科医院高水平中医医院“医疗机构制剂及中药新药研发”项目（GSP3-04） |
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| 中文摘要: |
| 祖国医学认为“肾精所化生之髓”在骨的形成、维持其功能等方面至关重要，肾气虚则髓减骨枯，骨量减少，发为骨质疏松症。膝骨关节炎同样以肾精亏虚为本，近年现代医学研究认为骨质疏松症与膝骨关节炎在流行病学、临床症状、发病机制等层面均有较强关联，二者常常共现或伴发，因此提倡将骨质疏松症与膝骨关节炎按照共病模式管理。本文拟结合现代医学研究对于骨质疏松症与膝骨关节炎相关性的认识，以膝关节软骨下骨“微骨折”征象为切入点，深入探讨祖国医学骨病范畴中“痿”与“痹”之间的联系与现代内涵。初步归纳二者合病的核心病机为“髓减骨枯”。故临证需紧扣“髓减骨枯”之本，持整体观念，积极采取异病同治或联合治疗，以期为临床老年骨质疏松症与膝骨关节炎的共病管理及防治提供祖国医学新视角。 |
| 英文摘要: |
| Chinese medicine believes that the "kidney essence of the marrow" in the bone formation, maintain its function is very important, kidney qi deficiency is marrow reduction bone dry, bone mass reduction, osteoporosis. Knee osteoarthritis is also based on kidney essence deficiency. In recent years, modern medical research believes that osteoporosis and knee osteoarthritis are strongly related from the aspects of epidemiology, clinical symptoms and pathogenesis, and the two are often co-occurring or concomitant. Therefore, it is recommended to manage osteoporosis and knee osteoarthritis according to the co-disease mode. Based on the understanding of the correlation between osteoporosis and knee osteoarthritis in modern medical research, this paper takes the sign of "microfracture" of knee subchondral bone as the starting point to deeply explore the connection and modern connotation between "flastie" and "Bi" in the category of bone diseases in Chinese medicine. The core pathogenesis of the combined disease was summarized as "marrow reduction and bone depletion". Clinical diagnosis should focus on the principle of "marrow reducing bone dry", hold the whole concept, and actively take the same treatment or combined treatment of different diseases. In order to provide a new perspective of Chinese medicine for the management and prevention of the comorbidity of senile osteoporosis and knee osteoarthritis. |
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