刘德玉“四辨”论治非创伤性股骨头坏死的中医药保髋治疗经验  

Liu Deyu's hip preservation experience in treating non-traumatic necrosis of femoral head with traditional Chinese medicine based on four differentiation thoughts

作　　者：刘楠 王军威[2] 刘德玉 LIU Nan;WANG Junwei;LIU Deyu(The First Clinical Medical College,Shanxi University of Chinese Medicine,Xianyang 712000,China;Shanxi University of Chinese Medicine,Xianyang 712000,China;The Affiliated Hospital of Shanxi University of Chinese Medicine,Xianyang 712000,China)

机构地区：[1]陕西中医药大学第一临床医学院,陕西咸阳712000 [2]陕西中医药大学,陕西咸阳712000 [3]陕西中医药大学附属医院,陕西咸阳712000

出　　处：《长春中医药大学学报》2023年第10期1095-1100,共6页Journal of Changchun University of Chinese Medicine

基　　金：咸阳市重大科技专项计划(2020k01-08);陕西省重点研发计划项目(2019SF-299);陕西省教育厅专项科研计划项目(22JC027);关中李氏骨伤流派传承工作室项目(陕中医药发2018-40)。

摘　　要：非创伤性股骨头坏死是临床常见且难治疾病。刘德玉教授认为,非创伤性股骨头坏死病病机主要包括瘀、痰、虚三方面,由气滞血瘀、肝肾亏虚及痰瘀蕴结而致的经络痹阻,骨失濡养。并提出“补肾活血生骨法”的治疗大法。在临证治疗中重视灵活运用关中李氏骨伤流派四辨思想对非创伤性股骨头坏死病进行论治,即辨证-辨中医证型,施治法方药;辨病-准确诊断,分期治疗;辨位-精确病位,精准治疗;辨体-辨体质特征,行个体化调护。为早中期非创伤性股骨头坏死的保髋治疗提供中医药的新思路及方法。Non-traumatic necrosis of femoral head is a common and refractory disease in clinical practice.Professor Liu Deyu believes that the pathogenesis of this disease mainly includes three aspects,namely blood stasis,phlegm and deficiency,and meridian obstruction and bones lost to mourishment are caused by stagnation of qi and blood stasis,liver-kidnety deficiency and phlegm and blood stasis.And Professor Liu Deyu puts forward the treatment method of"tonifying kidney,promoting blood circulation and promoting bone formation".In the clinical treatment,it is necessary to pay attention to the flexible use of the four differentiation ideas of Li's bone injury school in Guanzhong to treat this disease,that is,syndrome differentiation-differentiation of traditional Chinese medicine syndromes,and formulae and drugs for treatment carried out;disease differentiation-accurate diagnosis,and treatment by stages performed;location identification-accurate disease location,and precision treatment provided;differentiation of symptoms and signs-identification for the physical characteristics,and individualized nursing implemented.This method provides the new ideas and methods of traditional Chinese medicine for hip preservation treatment of non-traumatic necrosis of femoral head in the early and middle stages.

关 键 词：非创伤性股骨头坏死 四辨思想 保髋治疗 关中李氏骨伤流派 

分 类 号：R242[医药卫生—中医临床基础]