从少阴病论治颈椎病的理论探讨与炎症机制研究进展

A Theoretical Discussion on the Treatment of Cervical Spondylosis Based on the Theory of Shao Yin Syndrome and Recent Advances in Research on Inflammatory Mechanisms

摘要: 颈椎病以风寒痹阻型最为常见，传统八纲与脏腑辨证在精准辨治方面存在一定局限。六经辨证源自《伤寒论》，其中少阴病“阳虚寒凝”病机与风寒痹阻型颈椎病的证候特征高度契合。麻黄附子细辛汤作为少阴病代表方剂，具有温经发表、散寒止痛之功效。现代药理学研究证实，其单味药及复方可通过多途径调控肿瘤坏死因子-α (TNF-α)、白细胞介素-6 (IL-6)、白细胞介素-1β (IL-1β)等炎症因子，进而影响颈椎病疼痛的发生与维持。本文从少阴病理论出发，系统探讨麻黄附子细辛汤加味治疗风寒痹阻型颈椎病的中医理论依据，并结合炎症因子介导的疼痛机制，综述中医药调控该病的现代研究进展，以期为六经辨证指导颈椎病治疗提供理论支撑。

Abstract: Among cervical spondylosis cases, the “wind-cold obstruction” pattern is the most common; however, the traditional Eight Principles and Zang-Fu pattern differentiation methods have certain limitations in terms of precise diagnosis and treatment. The Six Channel pattern differentiation originates from the “Treatise on Cold Damage”; specifically, the pathogenic mechanism of “yang deficiency with cold congealing” in Shaoyin disease aligns closely with the clinical manifestations of the “wind-cold obstruction” pattern in cervical spondylosis. As a representative formula for Shaoyin disease, Ma Huang Fu Zi Xi Xin Decoction possesses the therapeutic effects of warming the meridians, expelling pathogens, dispelling cold and alleviating pain. Modern pharmacological research has confirmed that its individual herbs and the compound formula can regulate inflammatory factors such as tumour necrosis factor-α (TNF-α), interleukin-6 (IL-6) and interleukin-1β (IL-1β) via multiple pathways, thereby influencing the onset and maintenance of pain in cervical spondylosis. Based on the theory of Shaoyin disease, this paper systematically explores the theoretical basis in Traditional Chinese Medicine for the use of Ma Huang Fu Zi Xi Xin Decoction with modifications in the treatment of cervical spondylosis of the wind-cold obstruction type. By integrating the pain mechanisms mediated by inflammatory factors, it reviews modern research progress on the regulation of this disease through Traditional Chinese Medicine, with the aim of providing theoretical support for the treatment of cervical spondylosis guided by the Six Channel Differentiation.