Bone Proliferation (Osteophytes) - National Master of TCM Liu Bailing’s “Bone Proliferation Pain-Relief Pill”
22. Bone Proliferation (Osteophytes) - National Master of TCM Liu Bailing’s “Bone Proliferation Pain-Relief Pill”
National Master Liu Bailing. In the 1960s he pioneered the Bone Proliferation Pill (later renamed the Bone Proliferation Pain-Relief Pill), filling a gap in TCM treatment of bone proliferation both in China and abroad.
Pathogenesis
Bone proliferation (osteoarthritis, osteophytes/bone spurs) has its seat in the bone, with its root in the Kidney. The Kidney governs the bones and produces marrow; when Kidney jing deficiency is present, the bone marrow lacks nourishment and the bones are deprived of sustenance. Combined with prolonged overuse, local Qi and Blood circulation becomes sluggish, and stasis obstructs the bone collaterals, gradually forming osteophytes and bony overgrowths. In this formula, Prepared Rehmannia is the sovereign, tonifying and replenishing Kidney jing; Epimedium and Cistanche assist by warming Yang and transforming Qi, combined with Drynaria and Desmodium to supplement the bone and relieve pain; Spatholobi invigorates Blood, relaxes the sinews, and opens the collaterals; Rapeseed regulates Qi and prevents the clogging caused by tonic herbs. Together they accomplish the functions of reinforcing the Kidney and strengthening the bones, invigorating Blood, and relieving pain.
Formula Composition
Bone Proliferation Pain-Relief Pill (Pill formulation quantity)
Prepared Rehmannia 300g Desmodium 200g Cistanche 200g Spatholobi 200g
Epimedium 200g Rapeseed 100g Drynaria 200g
All are finely ground; honey is processed and formed into pills, each pill weighing 10g. Take 1 pill each time, 3 times a day, with plain warm water.
| Herb Group | Herb | Function |
|---|---|---|
| Sovereign | Prepared Rehmannia 300g | Nourishes Kidney Yin, fills essence and marrow, and strengthens the foundation of the bones. The large dose as sovereign directly supplements the material basis of the Kidney |
| Minister | Epimedium 200g, Cistanche 200g | Warm Kidney Yang, benefit essence and Blood, and strengthen sinews and bones. Epimedium rouses Kidney Yang, while Cistanche enters the Kidney to fill marrow; together with Prepared Rehmannia they mutually support Yin and Yang |
| Minister | Drynaria 200g, Desmodium 200g | Reinforce the Kidney and strengthen the bones, invigorate Blood and repair injury, also dispel Wind and Dampness. Drynaria excels in treating bone injuries and bone pain; Desmodium dispels Wind and Dampness and relieves pain |
| Assistant | Spatholobi 200g | Invigorates Blood and nourishes it, relaxes the sinews and opens the collaterals. Combined with Drynaria and the others, on the basis of reinforcing the Kidney and filling essence, it unblocks the collaterals and moves Blood to relieve pain |
| Envoy | Rapeseed 100g | Dissolves food stagnation, regulates Qi, and transforms phlegm. Used in a small dose as envoy, it prevents the clogging by the cloying tonic Kidney herbs, so that tonifying does not impede the Stomach, and opening does not injure the righteous Qi |
IV. Modifications
| Coexisting Pattern | Modified Herbs |
|---|---|
| Lumbar spine proliferation predominant | Add Eucommia (Aureus) 15g and Dipsacus (Xuduan) 15g, ground to powder and mixed into the pill, or decocted and taken with the pill, to strengthen the effect of reinforcing the Kidney and fortifying the lower back |
| Cervical spine proliferation predominant | Add Pueraria (Gegen) 20g and Turmeric (Jianghuang) 10g, decocted and taken with the pill, to direct the herbs upward, relax the sinews, and open the collaterals |
| Calcaneal osteophyte pain | Add Cimicifuga (Weilingxian) 15g and Achyranthes (Chuanniu Xi) 15g, decocted and taken with the pill, to direct the herbs downward, open the collaterals, and dissolve the osteophyte |
| Cold joint pain, aggravated by cold exposure | Add Processed Aconite (Fuzi) 9g and Cinnamon Twig (Guizhi) 10g, decocted and taken with the pill, to warm the meridians and disperse Cold |
| Wind-dampness with migratory joint pain | Add Angelica Pubescens (Duhuo) 10g and Gentiana Macrophylla (Qin Jiao) 12g, decocted and taken with the pill, to dispel Wind and Dampness |
| Abdominal distension and loose stools after taking the pill | Add Chinese Yam (Shan yao) 15g ground to powder and mixed into the pill, or substitute Rapeseed for White Cardamom (Baidoukou) 6g, to reinforce the Spleen and regulate Qi |
V. Summary
The entire formula uses Prepared Rehmannia to fill essence as sovereign, Epimedium and Cistanche to warm Yang as ministers, Drynaria and Desmodium to reinforce the bone and dispel Wind as assistants, Spatholobi to open the collaterals and invigorate Blood, and Rapeseed to regulate Qi and prevent clogging. Of the seven herbs, six enter the Kidney channel; reinforcing the Kidney is the fundamental treatment, while treating the bone is the secondary target. It is suitable for hypertrophic spondylitis, cervical spondylosis, calcaneal osteophytes, osteoarthritis, and the like, with the pattern of Liver-Kidney deficiency and stasis obstructing the bone collaterals - 1 month is one treatment course; 2-3 consecutive courses may be taken. Stop use temporarily during cold/fever episodes.
References
[1] Liu Bailing. Reflections on Treating Bone Proliferation Disease by Applying the Theories of Our Nation’s Medical System [J]. New Journal of TCM, 1973(2).
[2] Li Zhigang, Bi Lixun, Tan Zhenggang. Prof. Liu Bailing’s Experience in Treating Lumbar Bone Proliferation [J]. Chinese Journal of TCM Orthopaedics and Traumatology, 1999.
[3] State Pharmacopoeia Commission. Clinical Medication Guide of the Chinese Pharmacopoeia · Volume on TCM Patented Formulas [M]. Beijing: China Medical Science Press.
22. 骨質增生—國醫大師劉柏齡「骨質增生止痛丸」
劉柏齡國醫大師，60年代首創骨質增生丸（後稱骨質增生止痛丸），填補了中藥治療骨質增生的國內外空白。
病機
骨質增生（骨關節炎、骨刺）的病位在骨，病根在腎。腎主骨生髓，腎精虧虛則骨髓失充、骨骼失養，加之勞損日久，局部氣血運行不暢，瘀阻骨絡，逐漸形成骨刺、骨贅。本方以熟地黃為君填補腎精，淫羊藿、肉蓯蓉助陽化氣合骨碎補、鹿銜草補骨鎮痛，再加雞血藤活血舒筋通絡，萊菔子理氣防補藥壅滯，共成補腎健骨、活血止痛之功。
方藥組成
骨質增生止痛丸（丸劑製備量）
熟地黃 300g 鹿銜草 200g 肉蓯蓉 200g 雞血藤 200g
淫羊藿 200g 萊菔子 100g 骨碎補 200g
共為細末，煉蜜為丸，每丸重 10g。每次 1 丸，每日 3 次，白開水送下。
| 藥組 | 藥物 | 功用 |
|---|---|---|
| 君 | 熟地黃 300g | 滋腎陰、填精髓、壯骨之基。大劑量為君，直補腎中物質基礎 |
| 臣 | 淫羊藿 200g、肉蓯蓉 200g | 溫腎陽、益精血、強筋骨。淫羊藿興腎中之陽，肉蓯蓉入腎充髓，與熟地黃陰陽互濟 |
| 臣 | 骨碎補 200g、鹿銜草 200g | 補腎強骨、活血續傷，兼祛風溼。骨碎補善治骨傷骨痛，鹿銜草祛風除溼止痛 |
| 佐 | 雞血藤 200g | 活血補血、舒筋通絡。合骨碎補等藥，在補腎填精基礎上通暢經絡，行血止痛 |
| 使 | 萊菔子 100g | 消食導滯、理氣化痰。量輕為使，防諸補腎藥滋膩壅滯，使補而不礙胃、通而不傷正 |
四、加減法
| 兼證 | 加減藥物 |
|---|---|
| 腰椎增生為主 | 加杜仲 15g、續斷 15g，研末入丸或煎湯送服丸藥，增強補腎壯腰之力 |
| 頸椎增生為主 | 加葛根 20g、薑黃 10g，煎湯送服丸藥，引藥上行、舒筋通絡 |
| 跟骨骨刺疼痛 | 加威靈仙 15g、川牛膝 15g，煎湯送服丸藥，引藥下行、通絡消刺 |
| 關節冷痛、遇寒加重 | 加制附子 9g、桂枝 10g，煎湯送服丸藥，溫經散寒 |
| 兼有風溼、關節遊走痛 | 加獨活 10g、秦艽 12g，煎湯送服丸藥，祛風除溼 |
| 服丸後腹脹便溏 | 加山藥 15g 研末入丸，或易萊菔子為白豆蔻 6g，健脾理氣 |
五、小結
全方以熟地黃填精為君，淫羊藿、肉蓯蓉溫陽為臣，骨碎補、鹿銜草補骨祛風佐之，雞血藤通絡活血，萊菔子理氣防膩。七味藥中六味入腎經，補腎為本、治骨為標。適用於肥大性脊椎炎、頸椎病、跟骨骨刺、骨性關節炎等屬肝腎虧虛、瘀阻骨絡者——1個月為一療程，可連服2～3個療程。感冒發熱期間暫停服用。
參考文獻
[1] 劉柏齡. 運用祖國醫學理論治療骨質增生病的體會[J]. 新中醫，1973（2）.
[2] 李治罡，畢立新，譚振剛. 劉柏齡教授治療腰椎骨質增生症經驗[J]. 中國中醫骨傷科，1999.
[3] 國家藥典委員會. 中華人民共和國藥典臨床用藥須知·中藥成方製劑卷[M]. 北京：中國醫藥科技出版社.