调髓法论治血友病性骨质疏松症

“肾主骨生髓”是中医藏象理论的重要认知，认为肾藏功能紊乱是中医骨病发生发展的根本原因。浙派中医骨伤学家基于临床经验，在此理论基础上，结合古代文献及现代研究，创新性地将奇恒之腑“髓”对骨科疾病的影响作为一个独立的研究专题提出；系统构建出“髓系骨病”的理论体系；并创立对应的“调髓”治法。血友病性骨质疏松症属此类病症之一，其主要病机为先天之精功能异常，致血溢脉外，引发髓的藏泻失调，继而骨稳态失衡，发为骨痿。其治疗原则应为标本同治，内外调髓，恢复骨稳态。笔者以精、骨、髓、血的关系为立足点，对血友病性骨质疏松症的祖国医学与现代医学认识进行阐述，探讨运用“调髓法”对其进行治疗的思路。

Treatment of hemophilic osteoporosis with regulating the marrow

It is an important cognition of the theory of traditional Chinese medicine that the kidney dominates bone and produces marrow. It is believed that the dysfunction of the kidney viscera is the fundamental cause of the occurrence and development of bone disease in TCM. Based on clinical experience and this theory, combined with ancient literature and modern research, Zhejiang scholars of orthopedics and traumatologists have creatively put forward the impact of the marrow of extraordinary Fu-organ on orthopedic diseases as an independent research topic, systematically constructed a theoretical system of myeloid bone disease, and established the marrow regulating therapy. Hemophilia-induced osteoporosis is one of such diseases. Its main pathogenesis is the abnormality of congenital essence, which causes blood flow outside the pulse, triggering the imbalance of storage and diarrhea of the marrow, and then the imbalance of bone homeostasis, resulting in osteoporosis. The treatment principle should both treat the symptoms and the root causes, regulate the marrow internally and externally, and restore bone homeostasis. Based on the relationship among the essence, bone, marrow, and blood, this paper expounds the cognition of TCM and modern medicine of hemophilic osteoporosis, and probes into the treatment of hemophilia-induced osteoporosis with marrow regulating method.