国医大师张震从“骨肉相亲”论治全身性骨性关节炎经验

Master of traditional Chinese medicine ZHANG Zhen’s experience in the treatment of systemic osteoarthritis from “bone-muscle affinity”

关键词:  全身性骨性关节炎  骨肉相亲  名医经验  张震

Key words:  systemic osteoarthritis  bone-muscle affinity  famous doctor experience  ZHANG Zhen

摘要:

总结国医大师张震基于“骨肉相亲”理论治疗全身性骨性关节炎的临证经验。认为“骨失肉濡、肉失骨倚”是全身性骨性关节炎的关键病机，其中脾失健运致肌肉羸弱、肾失封藏致骨骼失养是引发“骨肉相亲”失调的核心因素，瘀血、痰浊等病理产物进一步阻滞骨肉经络，加重病情。治疗以“和调骨肉、健脾益肾”为基本治则，从“养肉以荣骨”“强骨以载肉”“通络以和骨肉”3个方面入手，针对脾弱肉虚、肾亏骨衰、痰瘀阻络兼肝郁的不同病机，分别运用黄芪健中汤、自拟补肾健骨汤、自拟疏调健骨汤进行加减治疗，兼顾日常调护以巩固疗效。

Abstract:

To summarize the clinical experience of ZHANG Zhen，a master of traditional Chinese medicine，in the treatment of systemic osteoarthritis based on the theory of “bone-muscle affinity”. It is believed that “bone loss and flesh loss” is the key pathogenesis of systemic osteoarthritis. Among them，muscle weakness caused by spleen failure and bone loss caused by kidney failure are the core factors that lead to the imbalance of “bone and muscle affinity”.Pathological products such as blood stasis and phlegm turbidity further block bone and muscle meridians and aggravate the disease. The treatment takes “harmonizing bone and meat，invigorating spleen and kidney” as the basic treatment principle. Starting from the three aspects of “nourishing meat to Ronggu” “strengthening bone to carry meat” and “dredging collaterals to harmonize bone and meat”，aiming at the different pathogenesis of spleen weakness and meat deficiency，kidney deficiency and bone failure，phlegm and blood stasis blocking collaterals and liver depression，Huangqi Jianzhong Decoction，self-made Bushen Jiangu Decoction and self-made Shutiao Jiangu Decoction were used for addition and subtraction treatment，taking into account daily nursing to consolidate the curative effect.