“骨肉不相亲”理论发微及其对中医治疗PMOP的指导作用探析

目的探讨中医骨肉不相亲理论的内涵及其在中医药和针灸治疗绝经后骨质疏松症(PMOP)中的应用前景。方法通过中医e百、《中华医典》等中医古籍数据库查阅春秋至清代有关骨肉不相亲及脾肾相关的古代文献,并检索2015年至2020年中国知网、万方、维普等中文期刊数据库中有关中医药和针灸治疗PMOP的实验及临床研究报道,进行系统整理及深入分析。结果中医骨肉不相亲理论最早见于《灵枢》,从春秋至清代的古籍中均有相关记载;后世医家据此认为其乃骨痿(即现代医学骨质疏松症)的病因病机,因此治疗原则由单纯补肾改为补肾健脾;近五年来的相关实验研究证实了该理论的正确性,临床报道也显示了补肾健脾中药或穴位治疗PMOP的优势。结论 骨肉不相亲理论经历代医家继承与发展使其内涵日趋丰富,实验和临床研究均证实其具有科学性和及POMP治疗中的应用价值。

The origin of the theory of disharmonious relationship between bone and muscle and its guiding role in the treatment of postmenopausal osteoporosis in traditional Chinese medicine

Objective To discuss the theory of disharmonious relationship between bone and muscle in traditional Chinese medicine (TCM) and its guiding role in the treatment of postmenopausal osteoporosis (PMOP). Methods The literature concerning the theory of disharmonious relationship between bone and muscle as well as spleen and kidney-related issues in ancient book databases TCMe100 and Chinese Medical Classics was searched from the Spring and Autumn period to Qing Dynasty. The relevant experimental and clinical research literature reports were retrieved in CNKI, WANFANG DATA, CQVIP, and other Chinese Journal Database from 2015 to 2020. Results The theory of disharmonious relationship between bone and muscle in Chinese medicine was first seen in the Lingshu, and was also recorded in the ancient books from the Spring and Autumn period to the Qing Dynasty. On this basis, later physicians believe that it is the etiology and pathogenesis of atrophic debility of bones (i.e. osteoporosis). Therefore, the treatment of osteopathy was changed from simply tonifying kidney to invigorating kidney and spleen. In the recent five years, the relevant experimental studies have confirmed the validity of this theory. The clinical reports have also shown the advantages of using herbs and acupoints which can invigorate kidney and spleen to treat osteoporosis. Conclusion The theory of disharmonious relationship between bone and muscle has become more and more popular in connotation through inheritance and development. Both experimental and clinical studies have proved its scientific and practical application value.