基于“筋出槽、骨错缝”论治膝骨关节炎  

Diagnosis and Treatment of Knee Osteoarthritis Based on Disease Mechanism of“Tendon Off-Position and Joint Subluxation”

作　　者：陆洁航 张旻[2] 李正言[1] 潘富伟 汪正明 葛海雅 沈知彼[1] 詹红生[1,2] LU Jiehang;ZHANG Min;LI Zhengyan;PAN Fuwei;WANG Zhengming;GE Haiya;SHEN Zhibi;ZHAN Hongsheng(SHI's Center of Orthopedics and Traumatology,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai,201203;Institute of Orthopedics and Traumatology,Shanghai Academy of Traditional Chinese Medicine)

机构地区：[1]上海中医药大学附属曙光医院石氏伤科医学中心,上海市201203 [2]上海市中医药研究院骨伤科研究所

出　　处：《中医杂志》2024年第7期755-759,共5页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(81973875,82074466);全国名老中医药专家传承工作室建设项目(国中医药人教函〔2022〕75号);上海市科学技术委员会“科技创新行动计划”医学创新研究专项(20MC1920600);上海市卫生健康委员会临床重点专科建设项目(shslczdzk03901)。

摘　　要：基于“筋出槽、骨错缝”的发病机理,结合现代解剖学和生物力学,明确膝部“筋出槽”和“骨错缝”的特征性表现及两者间的内在联系。通过梳理现代研究中“筋出槽、骨错缝”与膝骨关节炎的关系,认为“筋出槽、骨错缝”是膝骨关节炎发生、发展的关键病机,据此提出以饮食起居为先导、以手法整骨诊治于外、以中药内服调达于内、以导引练功贯始终的中医药综合治疗膝骨关节炎策略,以期提高临床疗效。Based on the pathogenesis of“tendon off-position and joint subluxation”,combined with modern anatomy and biomechanics,the characteristic manifestations of“tendon off-position”and“joint subluxation”of the knee and the intrinsic connection between them are clarified.Through sorting out the relationship between“tendon offposition and joint subluxation”and knee osteoarthritis(KOA)in modern research,it is believed that“tendon offposition and joint subluxation”is the key mechanism for the occurrence and development of KOA,and accordingly,it is proposed to take the diet as the guide,use bone manipulation for external diagnosis and treatment,use traditional Chinese medicine decoction for internal treatment,and use Daoyin exercise throughout the whole process as the strategy for KOA's comprehensive traditional Chinese medicine treatment to improve the clinical effectiveness.

关 键 词：膝骨关节炎 筋出槽 骨错缝 

分 类 号：R274[医药卫生—中医骨伤科学]