推拿防治膝骨关节炎患者中枢敏化的临床探讨  

Clinical Exploration of Tuina in Prevention and Treatment of Central Sensitization in Patients with Knee Osteoarthritis

作　　者：许辉[1,2] 周运峰[2] 时明伟[2] 王峥[2] 周航 李婉玉 郭娟 XU Hui;ZHOU Yunfeng;SHI Mingwei;WANG Zheng;ZHOU Hang;LI Wanyu;GUO Juan(The Third Affiliated Hospital to Henan University of Chinese Medicine,Zhengzhou Henan China 450008;Henan University of Chinese Medicine,Zhengzhou Henan China 450046)

机构地区：[1]河南中医药大学第三附属医院,河南郑州450008 [2]河南中医药大学,河南郑州450046

出　　处：《中医学报》2024年第2期286-289,共4页Acta Chinese Medicine

基　　金：国家自然科学基金项目(81874513);2022年度中原英才计划(育才系列)——中原青年拔尖人才项目{豫人才办〔2022〕5号};河南省科技攻关项目(222102310214);2022年河南省中医药科学研究专项课题项目(2022ZY1108);2023年度河南省中医学“双一流”创建科学研究专项项目(HSRP-DFCTCM-2023-7-09);2024年度河南省中医药科学研究专项课题项目(2024ZY3060)。

摘　　要：中枢敏化在膝骨关节炎患者中广泛存在,是导致膝骨关节炎疼痛的核心机制之一。当中枢敏化发生后,患者神经系统被“激惹”,进入持续的高反应状态,使疼痛阈值降低,并在外界刺激消失后继续维持疼痛,因此,中枢敏化对膝骨关节炎患者疼痛感知和管理造成极大负面影响。中医学“形神合一”理论认为,“形体”“神气”应在结构上保持高度协调,膝骨关节炎患者中枢敏化的发生是患者“形神同病”的集中体现。推拿可通过借助手法“调形”和传统功法“调神”,达到“形神同调”的良好效果,改善疾病症状。Central sensitization is widely present in patients with knee osteoarthritis and is one of the core mechanisms leading to pain in knee osteoarthritis.After central sensitization occurs,the patient′s nervous system is"stimulated"and enters a sustained high response state,reducing the pain threshold and continuing to maintain pain after external stimuli disappear.Therefore,central sensitization has a significant negative impact on pain perception and management in patients with knee osteoarthritis.In the theory of"unity of form and spirit"in traditional Chinese medicine,it is believed that the"form"and"spirit"should maintain a high degree of coordination in structure,and the occurrence of central sensitization in patients with knee osteoarthritis is a concentrated manifestation of the patient′s"injury both in form and spirit".Tuina can achieve a good effect of"harmony between form and spirit"by using techniques such as"shape adjustment"and traditional techniques such as"mind adjustment",and relieve disease symptoms.

关 键 词：膝骨关节炎 中枢敏化 推拿 “形神合一” 调形 调神 

分 类 号：R274.9[医药卫生—中西医结合]