膝骨关节炎针刀临床诊疗指南  

Clinical Guidelines for Acupotomy Treatment of Knee Osteoarthritis

作　　者：中华中医药学会针刀医学分会制定工作组 修忠标[2] 陈长贤[2] 张建新[2] 吕亚南 韦嵩 周钰 万全庆 曾维铨[2] 陈国强 黄惠榕[2] 蔡昭莲[2] 严国鸿[2] 翟宏业 林华阳[2] 刘洪[2] 张良志 Working Group of Acupotomy Medical Branch of China Association of Chinese Medicine;XIU Zhongbiao;CHEN Changxian;ZHANG Jianxin;LV Yanan;WEI Song;ZHOU Yu;WAN Quanqing;ZENG Weiquan;CHEN Guoqiang;HUANG Huirong;CAI Zhaolian;YAN Guohong;ZHAI Hongye;LIN Huayang;LIU Hong;ZHANG Liangzhi(不详;The People's Hospital Affiliated of Fujian University of Traditional Chinese Medicine,Fuzhou,Fujian 350004,China)

机构地区：[1]不详 [2]福建中医药大学附属人民医院,福建福州350004

出　　处：《康复学报》2023年第3期193-201,共9页Rehabilitation Medicine

基　　金：国家自然科学基金面上项目(81873315)。

摘　　要：膝骨关节炎是一种以关节软骨退变、继发性骨赘形成、软骨下骨硬化、滑膜炎症等为主要特征的慢性退行性疾病,属中医学“膝痹”范畴。随着全球人口老龄化加快,膝骨关节炎发病率不断上升,严重影响患者的生活质量。中医原创技术针刀疗法用于治疗膝骨关节炎具有显著优势,针刀疗法是以针刀医学理论为基础,将针刀作为治疗工具,以针的方式刺入人体,在人体内发挥针和刀的治疗作用,是治疗膝骨关节炎的有效方式之一。基于循证医学理念与方法制定的膝骨关节炎针刀临床诊疗指南具有重要意义,有助于规范膝骨关节炎的针刀诊疗,促进针刀诊治膝骨关节炎水平的提高。本指南从范围、定义、术语、中西医诊断、分级分期、针刀治疗以及不良反应与处理等方面对膝骨关节炎的诊断与针刀治疗流程进行规范梳理,旨在为临床、教学及科研工作等方面提供诊疗指导和参考。(1)诊断:分为中医诊断和西医诊断2个部分,包括诊断标准、分级标准、分期标准、中医辨证分型。(2)针刀治疗:主要包括治疗适应证、治疗禁忌证、治疗方案、治疗后注意事项、治疗频次与疗程、结局指标、针刀治疗安全性及常见不良反应与处理等7个方面。治疗方案主要明确了治疗原则、操作步骤、选取治疗点、其他协同疗法等方面的诊疗技术。不良反应包括常见不良反应和特殊不良反应,常见不良反应如晕针、断针、局部血肿形成和局部皮肤感染等,特殊不良反应如神经损伤、血管损伤、膝关节感染等。本指南以临床问题为导向,通过构建临床问题,制定文献筛选、证据分级,形成推荐意见、征求意见,最后规定了膝骨关节炎的诊断标准及针刀诊疗方案等内容,旨在为各级各类康复机构、中医医院或综合医院的骨伤科、疼痛科、康复科医师提供针刀治疗指导,具有较好的临床适用�Knee osteoarthritis is a chronic degenerative disease characterised by degeneration of articular cartilage,secondary bone formation,subchondral bone sclerosis and synovial inflammation,it belongs to the category of"Xibi"in Chinese medicine.With the accelerated ageing of the global population,the incidence of knee osteoarthritis is on the rise,which could have negative effects on the quality of life of patients.Acupotomy treatment is a form of treatment of traditional Chinese medicine,and has significant advantages in the treatment of knee osteoarthritis.Acupotomy treatment is an effective in treating knee osteoarthritis,it is based on the theory of acupotomy medicine,it uses an acupotomy as a treatment tool,piercing the human body with a needle,and exe-rting the therapeutic effects of the acupotomy in the human body.The clinical diagnosis and treatment guidelines for knee osteoarthritis based on the evidence-based medicine concept and method have significant implication,in standardizing the diagnosis and treatment of knee osteoarthritis,and improve the therapeutic effect of acupotomy treatment for knee osteoarthritis.This guideline summarizes the diagnosis and acupotomy treatment process of knee osteoarthritis from the aspects of scope,definition terminology,diagnosis of traditional Chinese and Western medicine,grading and staging,acupotomy treatment,and adverse reactions and management,aiming to provide guidance and reference for diagnosis and treatment in clinical,teaching and scientific research.1)Diagnosis:the 2 parts,Chinese medicine diagnosis and Western medicine diagnosis,including diagnostic criteria,grading criteria,staging criteria,and Chinese medicine identification and classification.2)Acupotomy treatment:including indications for treatment,contraindications to treatment,treatment protocol,post-treatment precautions,frequency and duration of treatment,outcome indicators,safety of acupuncture treatment,common adverse reactions and management.The treatment plan specifies the principles of treatment,the

关 键 词：膝骨关节炎 针刀 分期治疗 临床诊疗 指南 

分 类 号：R684.3[医药卫生—骨科学]