石氏伤科手法述略  

An Overview of Family Shi′s Orthopedic Manipulation

作　　者：赵珈琛 舒锦 顾怡雯 石珏 詹红生[2,3] ZHAO Jiachen;SHU Jin;GU Yiwen;SHI Jue;ZHAN Hongsheng(Shibei Hospital of Jing′an District in Shanghai,Shanghai,China,200435;Family Shi′s Orthopedic Medical Center,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai,China,201203;Institute of Orthopedic Research,Shanghai Academy of Traditional Chinese Medicine,Shanghai,China,201203)

机构地区：[1]上海市静安区市北医院,上海200435 [2]上海中医药大学附属曙光医院石氏伤科医学中心,上海201203 [3]上海市中医药研究院骨伤科研究所,上海201203

出　　处：《河南中医》2025年第3期471-478,共8页Henan Traditional Chinese Medicine

基　　金：上海市静安区卫生系统重点学科建设项目(2021ZD03);上海市静安区区科委课题项目(2022ZY02);上海市康复医学会健康管理研究基金项目(2024JGYQ13);上海市静安区医学重点学科建设项目(2024ZD03)。

摘　　要：石氏伤科以中医基础理论为指导思想,结合临床和武术的特点,融合“十三科一理贯之”的理念,创立了集理论、诊法、手法、针法、药物及练功为一体的石氏伤科学术体系。石氏伤科认为摸比法是一名伤科医师必须掌握的诊断方法,在诊疗疾病的过程中,始终贯穿“四诊合参”的辨证要点。石氏伤科治疗筋骨损伤的原则是“筋骨并重”,固定是骨折痊愈的决定性因素,手法是诊断和治疗的重要手段。以四诊八纲为辨证依据,强调内外兼治,整体论治,尤其要明确损伤的病因、病位和脏腑之间的关系。治疗时:(1)首要关注“气血”的变化,要做到气血兼顾,其中以血为主,以气为先;(2)审虚实,施补泻;(3)调治兼邪,要从“痰”论治;(4)注重整体观,要整体施治,内外兼顾。石氏伤科以“十三科一理贯之”作为指导思想,提出“手法是医者用双手诊断和治疗损伤的方法”,将手法分为骨折整复手法、固定手法、脱臼上骱手法、理筋手法,总结了十二字诀——“拔、伸、捺、正、拽、搦、端、提、按、揉、摇、抖(亦作‘转’)”。其中,“按、揉、摇、抖”主要用于离槽错缝、伤筋病,“拽、搦、端、提”用于脱位上骱,“拔、伸、捺、正”则用于骨折整复。石氏伤科指出:这十二法在临床运用上要临证施治,根据具体情况选择应用,无需特别区分。另外,理筋手法不仅限于伤筋病,骨折病复位的前后也需要理筋,可使肢体活动更为顺畅。石氏伤科手法诊治的现代病症有:颈椎病、肩关节周围炎、腰腿痛手法、膝骨关节炎等。Family Shi′s orthopedic manipulation is guided by fundamental theories of TCM,combined with clinical and martial arts characteristics,and integrates the concept of"thirteen categories unified by one principle."This has led to the creation of a comprehensive academic system encompassing theory,diagnosis,manipulation,acupuncture,medication,and exercise.Family Shi′s orthopedics believes that the"touch-comparison"method is a diagnostic method that a trauma physician must master.In the process of diagnosing and treating diseases,the key points of"comprehensive analysis of the four examinations"are always integrated.The principle of treating tendon and bone injuries in Family Shi′s Orthopedics is"equal attention to tendons and bones".Fixation is the decisive factor in fracture recovery,and manipulation is an important means of diagnosis and treatment.Based on the four diagnostic examinations and eight guiding principles,Family Shi′s orthopedics emphasizes both internal and external treatment and a holistic approach,especially identifying the cause,location,and organ relationships of injuries.Key treatment principles include:(1)Prioritizing changes in qi and blood,with a focus on blood as the primary and qi as the precursor;(2)Assessing deficiency and excess,applying tonification or reduction accordingly;(3)Treating accompanying pathogens by resolving phlegm;(4)Maintaining a holistic perspective,treating both internally and externally.Family Shi′s orthopedic system,guided by the concept of"thirteen categories unified by one principle,"defines manipulation as the method by which a physician diagnoses and treats injuries using their hands.Manipulation techniques are categorized into bone-setting,fixation,dislocation reduction,and tendon regulation,summarized into twelve key actions:pulling,stretching,restraining,correcting,tugging,holding,supporting,lifting,pressing,kneading,shaking,and rotating."Pressing,kneading,shaking,and rotating"are mainly for dislocation and muscle injuries,"tugging,holding,supporting,lif

关 键 词：石氏伤科手法 “四诊合参” “筋骨并重” 骨折整复手法 固定手法 脱臼上骱手法 理筋手法 

分 类 号：R244.15[医药卫生—针灸推拿学]