基于“筋伤、节错、骨病”辨证探讨膝骨关节炎的治疗策略  

Treatment strategy of knee osteoarthritis based on the ‘tendon injury,joints dislocation and bone disease’ theory

作　　者：林方政 林定坤[2] 陈树东[2] 曾令烽[2,3] 李永津 侯宇[2] 许文科[2] 赵第 刘军 LIN Fang-zheng;LIN Ding-kun;CHEN Shu-dong;ZENG Ling-feng;LI Yong-jin;HOU Yu;XU Wen-ke;ZHAO Di;LIU Jun(The Second Clinical Medical College,Guangzhou University of Chinese Medicine,Guangzhou 510405,China;Department of Orthopedics,Guangdong Provincial Hospital of Chinese Medicine,Guangzhou 510120,China;Bone and Joint Research Team of Degeneration and Injury,Guangdong Provincial Academy of Chinese Medical Sciences,Guangzhou 510120,China;Guangdong Second Traditional Chinese Medicine Hospital(Guangdong Province Engineering Technology Research Institute of Traditional Chinese Medicine),Guangzhou 510095,China)

机构地区：[1]广州中医药大学第二临床医学院,广州510405 [2]广东省中医院骨科,广州510120 [3]广东省中医药科学院骨与关节退变及损伤研究团队,广州510120 [4]广东省第二中医院(广东省中医药工程技术研究院),广州510095

出　　处：《中华中医药杂志》2022年第10期5832-5836,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金项目(No.81873314);广东省中医院中医药科学技术研究专项(No.YN2019ML08,No.YN2015MS15);广州市科技计划项目(No.202102010273);广东省中医药管理局项目(No.20225025)。

摘　　要：膝骨关节炎作为一种常见的慢性筋骨病,传统伤科辨证在临床诊疗过程中缺乏精准性和针对性。林定坤教授在中医筋骨失衡的理念基础上,结合现代解剖知识,将膝关节结构概括为“筋、节、骨”。临床上,先区分疼痛的部位,定病位在“筋”、在“节”、在“骨”;再结合按诊、症状、体征等信息,定病性,判断是“筋伤”“节错”还是“骨病”,形成筋伤疗筋,节错调节,骨病治骨,或筋、节、骨同治的膝骨关节炎治疗策略。新的膝骨关节炎筋骨辨证体系能更精准指导临床诊疗工作,从而提高临床疗效。As a common chronic bone and muscle disease, knee osteoarthritis lacks precision and pertinence in the clinical diagnosis and treatment of traditional traumatology syndrome differentiation. Professor LIN Ding-kun summarized the structure of knee joint as ‘tendons, joints and bones’ on the basis of the concept of imbalance between bones and muscles in traditional Chinese medicine and modern anatomical knowledge. Clinically, we should first distinguish the location of pain, and determine the location of the disease in tendons, joints and bones. Combined with the information of diagnosis, symptoms, signs,etc., determine the nature of the disease and judge whether it is ‘tendon injury’, ‘joint dislocation’ or ‘bone disease’, and form a treatment strategy of knee osteoarthritis by treating tendon injury, adjusting joint error, treating bone disease or treating tendon,joint and bone together. The new bone and muscle syndrome differentiation system of knee osteoarthritis can guide clinical diagnosis and treatment more accurately, thus improving clinical curative effect.

关 键 词：慢性筋骨病 筋骨失衡 筋骨辨证 膝骨关节炎 

分 类 号：R274.9[医药卫生—中西医结合]