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| Explanation of yin and yang theory in intervertebral disc degeneration and its clinical significance |
| SUN Daoxi1 WANG Nan2 XIE Lin1 |
1.Integrated Traditional Chinese and Western Medicine Hospital Affiliated to Nanjing University of Chinese Medicine Jiangsu Academy of Traditional Chinese Medicine, Jiangsu Province, Nanjing 210000, China;
2.Nanjing University of Chinese Medicine, Jiangsu Province, Nanjing 210000, China |
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Abstract Intervertebral disc degeneration is a complex process. At present, it is considered that the dynamic balance of catabolism and anabolism in the intervertebral disc environment is broken by many factors, which eventually leads to the apoptosis of nucleus pulposus cells. This complicated process coincides with the view of disease caused by “imbalance of yin and yang” in the theory of yin and yang. In the process of intervertebral disc degeneration, dynamic state, decreased blood vessels, increased osteoclasts, inflammatory factors, catabolism and apoptosis belong to yang, while static state, vascular proliferation, inflammatory factor inhibitory enzyme, anabolism and cell growth belong to yin. The explanation of yin and yang theory of intervertebral disc degeneration can develop the micro syndrome differentiation theory of traditional Chinese medicine, guiding clinical medication and functional exercise. Modern research guides the exploration of the mechanism of multi-target balance and the consideration of various factors of disease. This paper analyzes the mechanism of intervertebral disc degeneration from the theory of yin and yang, and constructs a bridge between the theory of traditional Chinese medicine and microstructure, which provides a new idea for the diagnosis and treatment of intervertebral disc degeneration.
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[1] Whatley BR，Wen X. Intervertebral disc（IVD）：structure，degeneration，repair and regeneration [J]. Materials Sci Engineering：C，2012，32（2）：61-77.
[2] 俞佳斌.椎间盘退行性变机制的研究进展[J].脊柱外科杂志，2017，15（6）：374-379.
[3] Adams MA，Lama P，Zehra U，et al. Why do some inter-vertebral discs degenerate，when others（in the same spine）do not? [J]. Clin Anat，2015，28（2）：195-204.
[4] 曹旺烽，陈长贤.椎间盘软骨终板退变的研究进展[J].中国中医骨伤科杂志，2016，24（10）：70-74.
[5] 徐增，孙斌，袁文，等.椎间盘钙化研究进展[J].中国脊柱脊髓杂志，2019，29（10）：936-939.
[6] Kozaci LD，Guner A，Oktay G，et al. Alterations in biochemical components of extracellular matrix in intervertebral disc herniation：role of MMP-2 and TIMP-2 in type Ⅱ collagen loss [J]. Cell Biochem Funct，2006，24（5）：431.
[7] 朱健，孙凯强，史建刚.巨噬细胞与椎间盘退变的研究进展[J].第二军医大学学报，2019，40（12）：1350-1355.
[8] Cannata F，Vadalà G，Ambrosio L，et al. Intervertebral disc degeneration：a focus on obesity and type 2 diabetes [J]. Diabetes Metab Res Rev，2020，36（1）：e3224.
[9] Alpantaki K，Kampouroglou A，Koutserimpas C，et al. Diabetes mellitus as a risk factor for intervertebral disc degeneration：a critical review [J]. Eur Spine J，2019，28（9）：2129-2144.
[10] Zhang X，Chen J，Huang B，et al. Obesity mediates apoptosis and extracellular matrix metabolic imbalances via MAPK pathway activation in intervertebral disk degeneration [J]. Front Physiol，2019，10：1284.
[11] 巩朝阳，赵光海，向高，等.脂肪细胞因子在椎间盘退变中的作用及其机制的研究进展[J].中国修复重建外科杂志，2020，34（3）：399-403.
[12] Cheng X. Circular RNA VMA21 protects against intervertebral disc degeneration through targeting miR-200c and X linked inhibitor-of-apoptosis protein [J]. Ann Rheumatic Dis，2018，77（5）：770-779.
[13] 于召龙，王云浩，黄凯，等.长链非编码RNA及其介导椎间盘退变机制的研究进展[J].中国矫形外科杂志，2019， 27（17）：1585-1588.
[14] 孙宏芝，孙中仪，田纪伟，等.环状RNA与椎间盘退行性变[J].中国矫形外科杂志，2019，27（24）：2262-2266.
[15] 倪祥惠.“阴阳交感”刍议[J].医学与哲学，2015，36（4）：79-80.
[16] 张登本.《内经》阴阳理论的研究[J].山西中医学院学报，2009，10（2）：2-8.
[17] Soukane DM，Shirazi-Adl A，Urban JP. Computation of coupled diffusion of oxygen，glucose and lactic acid in an intervertebral disc [J]. J Biomech，2007，40（12）：2645-2654.
[18] 劳杨骏，王继涛，吴承亮，等.椎间盘退变前驱因素终板退变研究现状[J].中华中医药杂志，2017，32（9）：4098-4101.
[19] Zehra U，Robson-Brown K，Adams MA，et al. Porosity and thickness of the vertebral endplate depend on local mechanical loading [J]. Spine（Phila Pa 1976），2015，40（15）：1173-1180.
[20] Fields AJ，Sahli F，Rodriguez AG，et al. Seeing double：a comparison of microstructure，biomechanical function，and adjacent disc health between double-and single-layer vertebral endplates [J]. Spine（Phila Pa 1976），2012， 37（21）：1310-1317.
[21] 袁丽丽，刘梅洁，樊新荣，等.“成骨-破骨”细胞阴阳理论阐释及意义[J].中国中医基础医学杂志，2019，25（6）：733-734，771.
[22] 柳根哲，孙旗，陈江，等.高静水压下益气活血汤通过p38MAPK信号通路对兔椎体终板软骨细胞的调控作用[J].现代中西医结合杂志，2018，27（10）：1027-1030， 1034.
[23] 易泳鑫，王秋虹，林兰，等.林兰基于阴阳理论调节胰岛素剂量经验浅析[J].辽宁中医杂志，2016，43（3）：482-483.
[24] 郁悦，程文秀，刁翰林，等.从中医阴阳理论探讨细胞自噬与子宫内膜异位性疾病的相关性[J].中华中医药学刊，2020，38（6）：42-45.
[25] 陈铁柱，王宁科，李晓声.腰痹舒干预腰椎间盘退变模型兔髓核组织水通道蛋白1、水通道蛋白3的表达[J].中国组织工程研究，2020，24（8）：1168-1173.
[26] Ratsep T，Minajeva A，Asser T. Relationship between neovascularization and degenerative changes in herniated lumbar intervertebral discs [J]. Eur Spine J，2013，22（11）：2474-2480.
[27] 孙磊涛，余洁茹，张乐吟，等.从中医阴阳观探究肿瘤表型辨识[J].中医杂志，2019，60（12）：1030-1034.
[28] 郭团茂，行艳丽，朱海云.早中期腰椎间盘退变机制及独活寄生汤治疗的研究进展[J].中国医药导报，2019， 16（15）：41-43，55.
[29] 王拥军，施祀，周重建，等.筋骨理论与治法[C]//中国康复医学会颈椎病专业委员会第十二次学术年会论文集，2010：4. |
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