基于《黄帝内经》"卫虚肉羸"理论辨治老年肌少症OA

Sarcopenia in the elderly is a geriatric syndrome primarily characterized by progressive muscle loss and increased physical frailty,resulting from age-related decline in bodily function and often complicated by multiple chronic conditions.This article is based on the theory of nutrient-defense in Huangdi's Canon of Internal Medicine,which states that the harmony of Zang-Fu organs and the smooth flow of nutrient-defense qi are important guarantees for muscle fullness and strength.Based on this,we propose that"deficiency of defense qi and emaciation of muscles"is the core pathogenesis of sarcopenia in the elderly.The pathogenesis of this disease often evolves with age,physical imbalance,and the onset of chronic diseases.Spleen deficiency with impaired transformation,deficiency of defense qi with failure in nourishment,and muscle loss are not only the pathogenic basis of sarcopenia in the elderly,but also run through the entire process of the disease,serving as the core of syndrome differentiation and treatment.The superposition of chronic diseases,deficiency of defense qi,and internal accumulation of pathogenic factors lead to physical decline and emaciation of muscles.The key to the development of diseases is the decline of spleen and kidneys,deficiency of defense qi and essence,reduction of physical fitness,and mental exhaustion.The treatment of this disease focuses on nourishing nutrient-defense qi,strengthening muscles,emphasizes the importance of invigorating spleen and stomach,and proposes using Zhigancao Decoction(炙甘草汤)as the basic formula to regulate defense qi and strengthen the foundation.According to the changes in the pathogenesis,the methods of reinforcing healthy qi to eliminate pathogenic factors and regulating nutrient-defense qi,as well as tonifying kidney and invigorating spleen,regulating defense qi and activating yang are adopted respectively.