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| 由“异病同治”理论探讨骨质疏松症与血管钙化共病机制 |
| Discussion on the comorbidity mechanism of osteoporosis and vascular calcification based on the theory of treating different diseases with the same therapy |
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| DOI：10.3969/j.issn.1006-7108.2025.05.017 |
| 中文关键词: 骨质疏松症 血管钙化 共病 能量代谢 异病同治 中医中药 |
| 英文关键词:osteoporosis vascular calcification comorbidity energy metabolism treating different diseases with the same therapy Chinese medicine |
| 基金项目:国家自然科学基金项目（82305275）；辽宁省自然科学基金项目（2022-YGJC-80，2022-YGJC-79）；国家中医药管理局高水平中医药重点学科建设项目（zyyzdxk-2023040） |
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| 中文摘要: |
| 随着人口老龄化，骨质疏松症（osteoporosis，OP）与血管钙化（vascular calcification，VC）经常以共病的形式存在，但在病理上却呈现相反的钙化特征，这被称作“钙化悖论”。二者共病显著增加了患者同时罹患脆性骨折和心血管疾病的风险，“钙化悖论”使药物治疗常常以加重另一疾病为代价，陷入顾此失彼的窘境。虽然二者共病，以及“钙化悖论”的具体机制尚未阐述清楚，这在一定程度上影响了治疗共病新药的研发，但研究表明OP与VC可能受与能量代谢有关的、共同的信号通路和激素等调控。中医学认为，表现为“钙化悖论”的OP和VC属于“异病同治”的范畴。肾失封藏、脾失健运是其共同的病机，补益脾肾是共同的治则治法。现代中医学认为，OP和VC可能与脾肾调控能量代谢功能失调有关。在中医理论指导下，对其共病机制的探讨可能为防治OP与VC提供新的研究思路，有助于疗效与安全性兼顾新药的开发。 |
| 英文摘要: |
| With the aging of the population, osteoporosis (OP) and vascular calcification (VC) often coexist in the form of comorbidity, but they have opposite calcification trend in pathology, which is known as the "calcification paradox". The coexistence of the twosignificantly increases the risk of patients suffering from fragility fractures and cardiovascular diseases at the same time.The "calcification paradox" often leads to the exacerbation of the other disease in drug treatment, resulting in a dilemma. Although the specific mechanism of the coexistence of the two and the "calcification paradox" has not been fully elucidated, which affects the development of new drugsto treat comorbidity to a certain extent, modern research shows that OP and VC are regulated by common signaling pathways and hormonesrelated to energy metabolism. Traditional Chinese medicine (TCM) believes that OP and VC, which manifest as the "calcification paradox", belong to the realm of "treating different diseases with the same therapy". The dysfunction of kidney in storing essence and the dysfunction of spleen in transportation is one of the common mechanisms of OP and VC, and tonifying spleen and kidney is a common principle of treatment. Modern TCM believes that, OP and VC are both related to the dysfunction of the spleen and kidney in regulating energy metabolism. Under the guidance of TCM theory, the exploration of the comorbidity mechanism between OP and VC, may provide new research ideas for the prevention and treatment of them, and help develop new drugs that can achieve efficacy and safety at the same time. |
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