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| 基于态靶辨证理论探讨肝肾阴虚型绝经后骨质疏松症的治疗 |
| Investigation of the treatment of postmenopausal osteoporosis based on the theory of state-target differential diagnosis and treatment |
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| DOI：10.3969/j.issn.1006-7108.2026.10.012 |
| 中文关键词: 绝经后骨质疏松症 肝肾阴虚 态靶辨证 靶方 靶药 |
| 英文关键词:postmenopausal osteoporosis liver and kidney Yin deficiency state-target differential diagnosis and treatment target side target drug |
| 基金项目:湖北省卫生健康委中医药科研立项项目（ZY2025L199，ZY2023M013）；武汉市卫生健康委员会中医药科研项目（WZ24Q27） |
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| 中文摘要: |
| 随着我国人口老龄化程度不断加深，绝经后骨质疏松症已成为临床常见疾病，若缺乏有效的预防与治疗措施，患者极易发生骨折等严重并发症，加重个人及家庭的经济负担。西医治疗主要依赖于抗骨质疏松药物，通过多种机制改善骨密度以延缓骨丢失进程。然而，长期使用部分西药有药物假期、甚至有潜在致癌等风险，限制了其广泛应用。中医学将绝经后骨质疏松症归类于“骨痿”“骨枯”等范畴，认为其病因病机主要为肝脾肾脏腑亏虚为主，其中肝肾阴虚证型最为常见。中医药治疗绝经后骨质疏松症以滋补肝肾、调和阴阳为核心，不仅能够有效改善绝经后骨质疏松症的症状，还可通过调节骨代谢、促进成骨和抑制破骨过程，在延缓疾病进展方面显示出良好疗效与安全性。“态靶辨证”是仝小林院士在继承中医辨证论治基础上，融合现代医学实践与药理学机制所提出的创新理论。该理论主张从“病态”出发，明确疾病全过程中的本虚标实与正虚瘀结态势，依“态”定“靶”，以“靶方”宏观调节整体功能失衡，以“靶药”精准干预具体病理靶点，实现从整体至局部、从宏观到微观的系统干预。在绝经后骨质疏松的辨治过程中，态靶辨证不仅有助于厘清各阶段核心病机，还能提升治疗的靶向性与个体化水平，推动中医诊疗向精准化、现代化转型。其辨证论治与现代靶向治疗理念的融合，体现出“态靶同调、效如桴鼓”的诊疗优势，具有重要的临床价值。 |
| 英文摘要: |
| With the continuous intensification of population aging in China, postmenopausal osteoporosis has become a common clinical condition. Without effective prevention and treatment measures, patients are highly susceptible to fractures and other serious complications, which in turn increase the economic burden on individuals and families. Western medicine mainly relies on anti-osteoporosis drugs, which improve bone mineral density through various mechanisms to slow down bone loss. However, the long-term use of some Western medications is associated with drug holidays and even potential carcinogenic risks, limiting their widespread application. In traditional Chinese medicine (TCM), postmenopausal osteoporosis falls under the categories of bone wilting and bone dryness. It is believed to be primarily caused by deficiencies in the liver, spleen, and kidney organs, with liver-kidney Yin deficiency being the most common pattern. TCM treatment focuses on nourishing the liver and kidneys and harmonizing Yin and Yang. This approach not only effectively alleviates symptoms but also regulates bone metabolism by promoting bone formation and inhibiting bone resorption, showing both therapeutic efficacy and safety in delaying disease progression. The concept of state-target pattern differentiation, proposed by Academician Tong Xiaolin, is an innovative theory that integrates traditional syndrome differentiation with modern medical practice, and pharmacological mechanisms. It advocates for understanding the pathological state of a disease, identifying the underlying deficiency and excess throughout its course, and determining treatment targets accordingly. With this approach, target formulas are used to regulate systemic functional imbalances, while targeted drugs intervene precisely at specific pathological sites, achieving a comprehensive strategy from holistic to localized, macro to micro-level intervention. In the treatment of postmenopausal osteoporosis, state-target pattern differentiation not only helps clarifying the core pathogenesis at different stages but also enhances the precision and personalized therapy. By integrating traditional pattern differentiation with modern targeted therapy concepts, this approach demonstrates the diagnostic and therapeutic advantage of co-regulating state and target, with effects in perfect unison, offering significant clinical value. |
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