非创伤性股骨头坏死血瘀证动态演变理论体系的构建与应用:从静态特征到动态规律OA

On the basis of significant achievements in static research on blood stasis syndrome(BSS)in non-traumatic osteonecrosis of the femoral head(NONFH),to further reveal the evolutionary law of the entire disease course,our team took the lead in proposing and systematically constructing the theoretical system of"dynamic evolution of BSS throughout the whole course of NONFH".The core viewpoint of this system is that BSS runs through the entire course of NONFH occurrence,development,and prognosis,and its severity shows a regular dynamic trajectory with disease progression:"initial appearance and gradual increase in the early stage(less→more)→significant peak in the middle stage(more)→gradual alleviation in the late stage(more→less)"."Stasis causing Bi(blockage)"is the core pathogenesis chain.Supported by the Key Program of the National Natural Science Foundation of China,the team has built a solid evidence chain through multi-dimensional studies:At the clinical syndrome level,large-scale data mining and syndrome element analysis revealed that the proportion of BSS-related syndrome types/manifestations presents a"low→high→low"evolution.At the molecular characterization level,network topological feature calculation and functional mining identified stage-specific core pathways(bone/lipid metabolism→immune inflammation/circulation→multi-system disorder),with animal models and candidate biomarkers verifying such dynamic correlation.At the imaging level,the BSS prediction model based on MRI and dynamic changes in DSA vascular indices consistently confirmed this evolutionary pattern.Based on this theory,an innovative"three stages(early,middle,late)and four types(Qi stagnation and blood stasis,phlegm-stasis blocking collaterals,meridian blockage,liver-kidney deficiency)"syndrome differentiation system was established,guiding the formation of stage-specific precise therapies:"strengthening spleen,resolving phlegm,activating blood and dredging collaterals(Jianpi Huogu Decoction)→tonifying Qi,activating blood,dredging meridians and relieving Bi(Huoxue Tongbi Decoction)→nourishing liver and kidney,replenishing essence and resolving stasis(Bushen Zhuanggu Decoction)",which showed significant clinical efficacy.This theoretical system represents a deepening and expansion of BSS research in NONFH,and provides important support for explaining the scientific connotation of BSS in chronic bone diseases,promoting the precise diagnosis and treatment of NONFH,and innovating the research paradigm of dynamic TCM syndromes.