目的 :调查绝经后女性低骨量人群中医证候,探讨鹿角补骨颗粒组方特点,为"治未病"理论指导下防治原发性骨质疏松症Ⅰ型提供依据。方法:分别纳入绝经后低骨量女性163例(低骨量组)、骨量正常女性132例(正常组),采集中医四诊信息,获得低骨量组中医证候,运用方证对应方法,分析鹿角补骨颗粒组方特点及其适用人群。结果:低骨量组阳虚证45.4%(肾阳虚27.0%、脾肾阳虚18.4%),肝肾阴虚证40.5%,血瘀气滞证14.1%,且较之正常组,低骨量组在口干、视物模糊、耳鸣、眼干、倦怠乏力、畏寒、腰痛、膝痛等临床症状方面更为明显(P<0.05),方证对应分析其基本病机是阴阳两虚且以阳虚为主,鹿角补骨颗粒药物分析提示其以右归丸为主且合用左归丸加减,并兼顾活血理气之法。结论:绝经后女性低骨量人群存在阴阳两虚且以阳虚为主的病机特点,以补肾温阳、壮骨益髓为主的鹿角补骨颗粒,契合其病机,可以应用于绝经后女性低骨量人群的防治方案中。

Objective:To perform a survy on the tradition Chinese medicine syndrome in the postmanopausal women with low bone mass,to explore the prescription principle of Lujiao Bugu granules,and to provide a basis for prevention the type I primary osteroporisis under the guidance of "treating the undiseased". Methods:There were 163 cases of postmenopausal women with low bone mass(low bone mass group) and 132 cases of healty women with normal bone mass(control group) included for this study. Using four diagnoses,information of patients was collected. Based on formula correspoinding with syndrome,the prescription principle of Lujiao Bugu granules and its recipents were analyzed. Results: In the low bone mass group,Yang deficiency accounted for 45.4%(kidney yang deficiency 27.0%,Yang deficiency of spleen and kidney 18.4%),Yin deficiency of liver and kidney accounted for 40.5%,blood stasis and Qi stagnation accounted for 14.1%,and the symtoms such as dry mouth,blurred vision,tinnitus,dry eyes,lassitude,aversion to cold,lambar pain,joint pain were more obvious than those in the control group(P<0.05). Based on the formula corresponding with the syndrome,the disease mechanism is deficiency of Yin and Yang,especially yang deficiency,and based on the herbs in the Lujiao Bugu granules,Lujiao Bugu granules is composed of modified Yougui pills added with Zuogui pills,also with some herbs to activate blood circulation and promote Qi movment. Conclusion:The postmenopausal women with low bone mass usually manifest as Yang deficiency,and the Lujiao Bugu granules could tonify kidney and warm Yang,strengthen bones and supplement marrow,which is very suitable for the disease mechanism. Hence it could be used for the postmenopausal women with low bone mass.