基于“命门学说”与“阴阳互济”探讨绝经后骨质疏松症的防治

CHINA MEDICAL HERALD Vol.16No.25September 2019

[基金项目]国家自然科学基金资助项目(81774185)。

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通讯作者

骨质疏松症是以骨量减少、骨质量受损及骨强度降低,导致骨脆性增加、易发生骨折为特征的全身性骨病[1]。绝经后骨质疏松症(postmenopausal osteoporo⁃sis,PMOP)属于原发性骨质疏松症,通常与衰老相关,其好发人群为缺乏雌激素的绝经后女性,主要是由于女性绝经后体内卵巢功能下降、雌激素的合成减少、骨偶联失衡,导致全身骨量减少、骨质量受损、骨强度降低及骨组织显微结构改变,进而使得骨脆性增加。查阅中医古代文献,没有骨质疏松症的命名,但其主要症状类似于骨痿、骨枯、骨极、骨痹、腰痛等疾病,其主要病机是精亏,即张景岳所言的“真阴不足”。基于

主要病机,采用“阴阳精气互济”的治法调补肾与命门

对防治PMOP 有较好效果[2-5]。本文基于张景岳“命门学说”及“阴阳互济”的学术思想,来探讨PMOP 的预

防和治疗。

1“命门”是生命调控之枢1.1命门学说的核心

命门一词,始见于《黄帝内经》,后于《难经》中出现命门学说起,一直众说纷纭。直至明代,张景岳创造性地将中医学基础理论与易理象数结合,提出医易同源[6]。《难经》记述命门的位置曰:“肾有两者,非皆肾也,左者为肾,右者为命门。”同时记述命门的功能曰:“命门者,精神之所舍,原气之所系,男子以藏精,女子

以系胞。”张景岳在此基础上,批判地完善了命门学

基于“命门学说”与“阴阳互济”探讨绝经后骨质疏松症的防治

史馨钰

任艳玲▲

辽宁中医药大学基础医学院,辽宁沈阳

110847

[摘要]骨质疏松症是威胁老年人健康的一种常见病。近几年随着绝经后妇女人数的增加,绝经后骨质疏松症

(PMOP)的预防以及治疗受到了社会的广泛关注,现已成为许多国家非常重视的保健课题。从中医角度,张景岳认为命门所藏的元阴、元阳可调控和平衡一身之阴阳,为五脏六腑功能的正常发挥提供不竭的原动力。若打破阴阳平衡,则会出现“水亏其源,火衰其本”的病理状态。本研究基于张景岳“命门学说”及“阴阳互济”的学术思想,

从“阴阳互济”的临床治疗方法对PMOP 进行探讨,为PMOP 的防治提供理论基础和新的治疗思路。[关键词]命门;阴阳互济;绝经后骨质疏松症[中图分类号]R22

[文献标识码]A

[文章编号]1673-7210(2019)09(a)-0110-04

Discussion on the prevention and treatment of postmenopausal osteoporo⁃sis based on the theory of “vital gate theory ”and “yin and yang interact⁃ing with each other ”

SHI Xinyu REN Yanling ▲School of Basic Medicine,Liaoning University of Traditional Chinese Medicine,Liaoning Province,Shenyang

110847,

China

[Abstract]Osteoporosis is a common disease that threatens the health of the elderly.With the increase of the number

of postmenopausal women in recent years,the prevention and treatment of postmenopausal osteoporosis (PMOP)has been paid much attention by the society and has become a health care topic that many countries attach great impor⁃tance to.From the perspective of traditional Chinese medicine,Zhang Jingyue believes that the yuan yin and yuan yang stored in the vital gate can regulate and balance the yin and yang of the whole body,providing inexhaustible driving

force for the normal development of the functions of the five zang viscera and six fu viscera.If the balance of yin and yang is broken,the pathological state of “water loses its source,fire loses its source”will appear.Based on Zhang Jingyue′s academic ideas of “vital gate theory”and “yin and yang interacting with each other”,this study reviews the clinical treatment methods of “yin and yang interacting with each other”of PMOP,so as to provide theoretical basis

and new treatment ideas for the prevention and treatment of PMOP.

[Key words]Vital gate;Yin and yang interacting with each other;Postmenopausal osteoporosis

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