不同临床阶段的大骨节病中西医治疗的研究进展  

Progress in the treatment of Kashin-Beck disease in different stages with traditional Chinese and Western medicine

作　　者：骞童 寇久社[2] 郭雄 Qian Tong;Kou Jiushe;Guo Xiong(The Second Clinical Medical College of Shaanxi University of Traditional Chinese Medicine,Xianyang 712000,China;Department of Pain,the Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine,Xianyang 712000,China;Institute of Endemic Diseases,School of Public Health,Xi'an Jiaotong University Health Science Center,Xi'an 710061,China)

机构地区：[1]陕西中医药大学第二临床医学院,咸阳712000 [2]陕西中医药大学第二附属医院疼痛科,咸阳712000 [3]西安交通大学医学部公共卫生学院地方病研究所,西安710061

出　　处：《中华地方病学杂志》2024年第2期165-172,共8页Chinese Journal of Endemiology

基　　金：咸阳市科学技术局-社会发展项目(2021ZDYF-SF-0042)

摘　　要：大骨节病(Kashin-Beck disease,KBD)是一种地方性、多发性、对称性、变形性骨关节病,好发于发育期儿童的骨骺生长板和关节软骨,可致软骨细胞变性、降解和坏死,临床上依据患者病变范围和畸形程度分为早期、Ⅰ度、Ⅱ度和Ⅲ度4个阶段。KBD的病因与发病机制至今仍不清楚,针对此病尚无特效药,对各种医学干预手段有效性的研究也较少。目前,KBD的治疗多参照中西医关于骨关节炎的相关方法。本文以现有研究作为基础,依据KBD的疾病分期对其中西医治疗方法进行了总结分析,提出应在阶梯化和个体化原则下,中西医并重治疗,并以药物治疗为主、手术治疗为辅,最大程度减轻患者疼痛、保护关节和预防损伤,以期为临床治疗KBD提供参考依据。Kashin-Beck disease(KBD)is an endemic,multiple,symmetrical and deformable osteoarthropathy that is more common in the epiphysis growth plate and articular cartilage of developing children and can cause degeneration,degradation and necrosis of chondrocyte.Clinically,it is divided into four stages based on the extent of the patient's lesion and degree of deformity:early stage,gradeⅠ,gradeⅡand gradeⅢ.The etiology and pathogenesis of KBD are still unclear,there is no specific drug for this disease.There is also limited study on the effectiveness of various medical interventions.Currently,the treatment of KBD mostly refers to the relevant methods of traditional Chinese and Western medicine for osteoarthritis.This article is based on the existing study,and summarizes and analyzes the Chinese and Western medicine treatment methods for KBD based on the disease staging.It is proposed that both Chinese and Western medicine should be treated under the principles of ladder and individualization,with drug therapy as the main treatment and surgical treatment as the auxiliary treatment,so as to minimize patient pain,protect joints and prevent injuries,and provide reference for clinical treatment of KBD.

关 键 词：大骨节病 地方病 阶梯化治疗 双醋瑞因 青藤碱 

分 类 号：R684.1[医药卫生—骨科学]