基于"热痹-髓亏-骨损"动态病机论治强直性脊柱炎OA

Based on the understanding of"kidney storing essence and marrow nourishing bone",and in combina-tion with the modern pathological characteristics of ankylosing spondylitis(AS),this paper systematically elucidates the dynamic pathogenesis evolution of"heat bi(inflammatory activity)-marrow deficiency(bone marrow edema)-bone damage(bone structural damage)"in AS.It is proposed that in the heat bi stage,there is kidney deficiency with pathogenic invasion and heat congesting the meridians.In the marrow deficiency stage,heat consumes kidney essence,leading to marrow injury and collateral obstruction.In the bone damage stage,kidney exhaustion and marrow empti-ness occur,with phlegm-stasis congealing on bone.Accordingly,a stage-specific treatment strategy for AS is estab-lished.In the heat bi stage,treatment focuses on supplementing the kidney and replenishing essence,clearing heat and unblocking collaterals.In the marrow deficiency stage,the main approach is to supplement the kidney and bene-fit marrow,unblock collaterals and reduce edema.In the bone damage stage,it is suggested to supplement the kidney and replenish essence,benefit marrow and strengthen bone,resolve phlegm and expel stasis.