论“筋主骨从”观念在慢性筋骨病损诊疗中的临床意义  

Clinical significance of concept of “tendon domination and bone subordination” in diagnosis and treatment of chronic tendon and bone diseases

作　　者：元唯安[1,2,3] 詹红生 杜国庆[1,2,3] YUAN Weian;ZHAN Hongsheng;DU Guoqing(Shi' s Traumatology Medical Center of Shugiiang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Institute of Bone Trauma,Shanghai Academy of Traditional Chinese Meclizine,Shanghai 201203,China;Zlian Hongslieng Studio of Academic Experience of Shanghai Famous Doctors in TCM,Shanghai 201203,China)

机构地区：[1]上海中医药大学附属曙光医院石氏伤科医学中心,上海201203 [2]上海市中医药研究院骨伤研究所,上海201203 [3]詹红生上海市名老中医学术经验研究工作室,上海201203

出　　处：《上海中医药杂志》2019年第9期12-15,共4页Shanghai Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81403414、81473702、81503596);上海市教委优秀青年教师基金项目(szy08079);上海市卫计委“杏林新星”计划项目(ZYSNXD011-RC-XLXX-20130049);上海市卫计委重中之重临床医学重点学科(中医骨伤科学)建设项目(2017ZZ02024);上海市卫计委中医药新兴交叉学科(工效筋骨学)建设项目(2017-024);上海市卫计委詹红生上海市名老中医学术经验研究工作室建设项目(SHGZS-2017025,SZYMZYGZS4013)

摘　　要：生理状态下,筋附骨、骨撑筋,二者的自身结构和功能特点决定了筋与骨之间是筋主骨从的关系,这是维系筋骨和合的前提和根本。当直接或间接暴力作用下,筋骨系统遭受严重急性损伤时,治当筋骨并重;而对于慢性筋骨病损而言,其关键病理环节是筋出槽、骨错缝,治疗的重点应是筋伤,故而治则又当筋主骨从。在慢性筋骨病损中秉持“筋主骨从”的观念进行诊断与治疗,有助于早期发现病变、提高临床疗效,故而本文主要目的在于唤起中医骨伤科临床工作者对“筋伤”的高度重视。Tendons adhere to bones and bones support tendons in physiological state, and the relationship between tendons and bones is tendon domination and bone subordination, which is determined by their own structures and functional characteristics, and is the premise and foundation of maintaining the harmony between tendons and bones. When tendons and bones suffer severe acute injury under direct or indirect violence, they should be paid equal attention in treatment. As for chronic tendon and bone lesions,the key pathological link is tendons deviating from groove,bone dislocation,and treatment should focus on tendon injury,therefore tendon domination and bone subordination is the therapeutic principle. Adhering to the concept of " tendon domination and bone subordination"in diagnosis and treatment of chronic tendon and bone diseases is helpful for early detection of lesions and improvement of clinical efficacy. The main purpose of this paper is to call for attention to"tendon injury"in diagnosing and treating diseases in orthopedics and traumatology.

关 键 词：筋骨关系 筋主骨从 筋出槽 骨错缝 慢性损伤 中医治则 

分 类 号：R274[医药卫生—中医骨伤科学]