筋骨辨证-筋骨并重  

Differentiation of Bones—emphasis on both Sinews and Bones Survey

作　　者：钟雯[1] 曹锐[2] 

机构地区：[1]辽宁中医药大学研究生学院 [2]辽宁中医药大学针灸推拿学院推拿教研室,沈阳110032

出　　处：《实用中医内科杂志》2017年第2期73-76,共4页Journal of Practical Traditional Chinese Internal Medicine

基　　金：国家973计划(2013CB532004)~~

摘　　要：巢元方《诸病源候论》最早提出"筋骨辨证",吴谦《医宗金鉴·正骨心法要旨》对骨度、损伤内外治法记述尤为详细,"筋骨并重"为核心,贯穿全书,发展了"筋骨辨证",为现代正骨推拿治疗的四大原则之一。筋,不仅指经络"筋"(筋膜、筋络、筋腱),也包括皮肉、脉等,涵盖现代解剖学肌肉、韧带、筋膜、软骨;骨乃奇恒之府,具有正、刚特性,维持整体形态,保卫内部组织,构成人体结构基础;筋约束骨,骨伸张筋肉,相互协调,维持人体运动;筋骨生理相互为用,病理相互影响,与肝、肾相应,骨关节病治疗应整体调摄,重在肝脾肾。"筋骨辨证"是手法治疗的前提,明确筋伤与骨伤主次,辨证施术,手法操作注重松筋与正骨,既重视骨折复位,又重视理筋,保护软组织;正骨-骨折和脱位,恢复骨与关节正常解剖位置;理筋-软组织急、慢性损伤,肌肉痉挛疼痛,仅采用松筋手法,反复按压局部,可加重关节错位,产生剧烈疼痛及肌肉痉挛;将"筋骨并重、辨病诊治"与现代医学手段巧妙结合,辨证施术,也当注重筋、骨与脏腑、经络、气血之间的关系,中药、针灸等内外兼治,充分施展"筋骨辨证"治疗优势。"筋骨辨证"应用于临床是正骨推拿学发展重点。CHAO Yuanfang the pathogenic theory of greases first suggested the physique differentiation. WU Qian ＂golden mirror of medicine, the heart essence of bone setting＂, particularly with external treatment of injury, ＂emphasis on both sinews and bones＂ as the core, through the book, the development of ＂bones, one of the four principles of dialectical treatment for modern bonesetting massage. Bar, not only refers to the＂ meridian tendons（fascia, tendons and tendon）, Including the flesh, veins, covering modern anatomy of muscle, ligament, fascia, cartilage; the bone is the odd and permanent house, with the positive, just characteristics, to maintain the overall shape, defend the internal organization, constitute the foundation of human body structure; reinforcement binding bone, bone stretching muscles, coordination and maintenance of human motion; and each other with physiological and pathological interaction, and liver, kidney corresponding, treatment of bone and joint disease should be the overall adjustment, focusing on the spleen and kidney. ＂Bones syndrome＂ is the premise of manipulation therapy, clear tendon injury and bone differentiation treatment, primary and secondary, pay attention to loose muscle and bonesetting manipulation. Both attach importance to fracture reduction, but also pay attention to the reinforcement, the protection of soft tissue; bone- fracture and dislocation, restoration of normal anatomical position of bone and joint; in acute, chronic injury, muscle spasm and pain, only using loose muscle technique, repeated pressing of the local, can increase the joint dislocation, resulting in severe pain and muscle cramps; the ＂bones, disease diagnosis and treatment＂ Cleverly combined with modern medical methods, dialectical treatment, also when the focus on muscle, bone and viscera, meridian, Qi and blood relationship, traditional Chinese medicine, acupuncture and other internal and external treatment, give full play to advantages of ＂bones＂ syndrome differentiation treat

关 键 词：筋骨辩证 正骨推拿 筋骨并重 正骨 理筋 筋膜 筋络 筋腱 肌肉 韧带 软骨 巢元方 诸病源候论 吴谦 医宗金鉴 

分 类 号：R274.120.5[医药卫生—中医骨伤科学]