基于五体理论阐述肌骨系统的代偿  

Explaining the Compensation Mechanism of the Musculoskeletal System Based on the Five-Body Theory

作　　者：翟天军 冯伟 宋永嘉 张增乔 汪伍 ZHAI Tianjun;FENG Wei;SONG Yongjia;ZHANG Zengqiao;WANG Wu(School of Rehabilitation Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai,China,201203;The Second Rehabilitation Hospital of Shanghai,Shanghai,China,201203)

机构地区：[1]上海中医药大学康复医学院,上海201203 [2]上海市第二康复医院,上海201203

出　　处：《河南中医》2024年第10期1537-1541,共5页Henan Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81873328);上海市科学技术委员会项目(18401900300);2019上海市体育科技“腾飞计划”项目(197005)。

摘　　要：中医五体理论是对肌骨系统的高度概括,包括皮、肉、脉、筋、骨五个部分,对应解剖结构中的韧带、关节囊,神经、血管,肌肉,浅筋膜和骨。基于五体理论,认为五体痹会由外而内,以皮、肉、脉、筋、骨依次传变,肌骨系统为浅筋膜、肌肉、神经、血管、韧带、关节囊、骨膜、骨的依次代偿。五体理论可为现代肌骨系统疼痛代偿提供良好的理解方式,更好地确定肌骨系统疼痛的损伤部位。早期疼痛可能是浅筋膜、肌肉(皮、肉)的损伤,可针对皮、肉进行治疗;中期疼痛可能是神经、血管、肌腱(脉、筋)的损伤,可以针对筋、脉进行治疗;长期慢性疼痛可能是骨的结构的损伤,可以针对骨膜、骨进行治疗。五体理论可为现代肌骨系统疼痛代偿提供良好的理解方式,为临床肌骨系统疼痛治疗给予启示,应予以关注。The TCM five-body theory offers a comprehensive understanding of the musculoskeletal system,categorizing it into five components:tendons,vessels,flesh,skin,and bones.These correspond to the anatomical structures of ligaments,joint capsules,nerves,blood vessels,muscles,superficial fascia,and bones.Based on the five-body theory,it is believed that pathological changes progress from the exterior to the interior,with transmission from the skin,flesh,vessels,tendons,and finally to the bones.The musculoskeletal system compensates sequentially through the superficial fascia,muscles,nerves,blood vessels,ligaments,joint capsules,periosteum,and bones.This theory provides a valuable perspective for understanding the compensation mechanism in modern musculoskeletal pain and helps in identifying the specific injury sites within the system.Early-stage pain may involve damage to the superficial fascia and muscles(skin and flesh),which can be treated accordingly.Mid-stage pain may involve injury to the nerves,blood vessels,and tendons(vessels and tendons),necessitating targeted treatment.Chronic long-term pain is often associated with damage to bone structures,requiring treatment focusing on the periosteum and bones.The five-body theory offers insights for modern musculoskeletal pain compensation and provides guidance for clinical pain management in the musculoskeletal system,which should receive further attention.

关 键 词：五体理论 肌骨系统 代偿 疼痛 

分 类 号：R223[医药卫生—中医基础理论]