基于“治未病”理论探讨中西医防治激素性股骨头坏死

Exploring the Prevention and Treatment of Steroid-Induced Osteonecrosis of the Femoral Head Using Traditional Chinese and Western Medicine Based on the Theory of “Preventive Treatment of Disease”

摘要: 激素性股骨头坏死(steroid-induced osteonecrosis of the femoral head, SONFH)是临床上最为常见的非创伤性股骨头坏死之一，常会导致股骨头血运受损从而引起一系列的骨内病理变化致使股骨头塌陷，最后导致患者髋关节处疼痛伴活动受限，进一步发展有致残可能性，最终演化为需要行全髋关节置换(total hip arthroplasty, THA)手术治疗，严重影响患者生活质量，是一种难治性骨科疾病；该病的主要病因是因为由于糖皮质激素(glucocorticoid, GC)的滥用；作为临床上广泛而有效的抗炎及免疫抑制剂，GC被大量用于临床一线；中医的“治未病”理论首见于《黄帝内经》，其主要思想有未病先防、即病防变、瘥后防复三个阶段，该思想被广泛用于指导疾病的防治，本文探讨将“治未病”理论思想应用于激素性股骨头坏死的中西医防治中，以期对临床提供一定的参考。

Abstract: Steroid-induced osteonecrosis of the femoral head (SONFH) is one of the most common non-traumatic osteonecrosis clinically, often leading to damage to the blood supply of the femoral head, resulting in a series of intraosseous pathological changes leading to the collapse of the femoral head, and finally leading to pain in the hip joint with limited mobility, further development with the possibility of disability, and finally evolved into the need for Total hip arthroplasty (THA) surgical treatment, which seriously affects the quality of life of patients, and is a refractory orthopedic disease; The main cause of the disease is due to the abuse of glucocorticoid (GC); As a clinically extensive and effective anti-inflammatory and immunosuppressant, GC is widely used in the clinical frontline; The theory of “preventive treatment of disease” of traditional Chinese medicine first appeared in the “Inner Canon of Huangdi”. Its main ideas are three stages of prevention before disease, that is, disease prevention and degeneration, and prevention and recovery after malaria, which is widely used to guide the prevention and treatment of diseases. This paper discusses the application of the theoretical idea of “preventive treatment of disease” to the prevention and treatment of steroid-induced osteonecrosis of the femoral head in traditional Chinese and Western medicine, in order to provide a certain reference for clinical practice.