补肾活血方剂治疗膝骨关节炎研究进展  

Research Progress in the Treatment of Knee Osteoarthritis with Kidney Tonifying and Blood Circulation Activating Prescription

作　　者：李晓峰 刘元禄[2] 关雪峰[1] 杨永菊[2] LI Xiaofeng;LIU Yuanlu;GUAN Xuefeng;YANG Yongju(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China;Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,Liaoning,China)

机构地区：[1]辽宁中医药大学,辽宁沈阳110847 [2]辽宁中医药大学附属医院,辽宁沈阳110032

出　　处：《辽宁中医药大学学报》2023年第10期142-146,共5页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：国家中药管理局中医药特色康复服务能力提升工程项目(中央)(2020-1);国家卫生健康委医药卫生科技发展研究中心项目(2019ZX09301125);辽宁省中医药管理局刘元禄辽宁中医大师传承工作室建设项目(2022-1)。

摘　　要：膝关节骨性关节炎(knee osteoarthritis,KOA)是一种慢性、退行性骨与肌肉疾病之一,多以“骨痹”“膝痹”称之,主要表现为疼痛、活动障碍,具有高致残率,影响人们生活质量。目前西医早期治疗主要是予非甾体类抗炎药物消炎止痛,但由于药物疗效不稳定,治疗后病情易反复。从中医整体观念、辨证论治出发,肾元衰退、正气虚耗是发生KOA的根本所在,作为替代疗法,补肾活血是治疗膝骨关节炎最常用的方法之一,这类方剂已被许多临床医生使用与推荐,它是根据中医理论以“补肾”“活血”为主的中药复方,近些年来针对补肾活血类中药复方治疗膝骨关节炎的文献研究不胜其数,其组方治疗KOA的作用机制可归纳为降低促炎因子与疼痛因子、减缓关节软骨降解、调控软骨细胞增殖与氧化作用、抑制软骨细胞凋亡、调节淋巴回流等几方面。该文将从以上几个方面对补肾活血类方剂治疗KOA的作用机制进行综述,为未来的学者研究提供支持与参考。Knee osteoarthritis is one of the chronic degenerative bone and muscle diseases,mostly referred to as“bone arthralgia”or“knee arthralgia”.It is mainly manifested as pain and activity disorder,which affects people'quality of life and leads to high disability rate.Right now,the early treatment of Western medicine is mainly non steroidal anti-inflammatory drugs for inflammation and relieve pain.However,due to the unstable drug efficacy,the condition is easy to recur after treatment.From the overall concept of TCM and dialectical treatment,the root of KOA is the depletion of vital energy.As an alternative therapy,tonifying kidney and activating blood circulation is one of the most commonly used methods to treat knee osteoarthritis.This kind of prescription has been used and recommended by many clinicians.The mechanism of action of the prescription for KOA can be summarized as reducing pro-inflammatory factors,slowing down the degradation of articular cartilage,regulating chondrocyte proliferation and oxidation,inhibiting chondrocyte apoptosis,and regulating lymphatic flow back.In this paper,we will review the mechanism of action of kidney tonifying and blood activating prescription in the treatment of KOA from the above aspects to provide support and reference for future research.

关 键 词：补肾活血 膝骨关节炎 作用机制 综述 

分 类 号：R274[医药卫生—中医骨伤科学] R684.3[医药卫生—中医学]