骨与关节退行性疾病的“三方辨证”体系  

‘Tripartite diagnostic and therapeutic differentiation’system for degenerative bone and joint diseases

作　　者：林方政 陈树东[3,4] 李永津 苏国义[3,4] 赵兵德 侯宇[3,4] 祁冀 曾小龙[3,4] 詹吉恒[3,4] 高梓博 林定坤 LIN Fangzheng;CHEN Shudong;LI Yongjin;SU Guoyi;ZHAO Bingde;HOU Yu;QI Ji;ZENG Xiaolong;ZHAN Jiheng;GAO Zibo;LIN Dingkun(Wangjing Hospital of China Academy of Chinese Medical Sciences,Bejing 100102,China;The Second Clinical Medical College,Guangzhou University of Chinese Medicine,Guangzhou 510405,China;Department of Orthopedics,Guangdong Provincial Hospital of Chinese Medicine,Guangzhou 510120,China;Guangzhou Key Laboratory of Cervical Mechanobiology,Guangzhou 510120,China)

机构地区：[1]中国中医科学院望京医院,北京100102 [2]广州中医药大学第二临床医学院,广州510405 [3]广东省中医院骨科,广州510120 [4]广州市颈椎力学生物学重点实验室,广州510120

出　　处：《中华中医药杂志》2025年第2期495-500,共6页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：岐黄学者工作室(No.国中医药人教函[2022]6号);林定坤广东省名中医传承工作室(No.0103030912);广东省中医院科学技术专项“岭南骨伤科流派传承工作室”(No.中医二院[2013]233号);广东省中医院科学技术专项“国医大师石仰山学术经验传承工作室”(No.中医二院[2014]89号);国家自然科学基金青年科学基金项目(No.82205150)。

摘　　要：骨与关节退行性疾病是骨伤科的常见病、多发病。文章基于岭南骨伤流派、石氏伤科流派理论,结合现代医学认识及临证经验,提出“三方辨证”体系。该体系细化筋骨分型,总结“三方病机”(筋骨失衡、气血失和、兼邪积聚),建立相应的“三方治则”(平衡筋骨、调和气血、并除兼邪),并提出运用手法、针灸、中药、导引等方法组成中医疗法“组合拳”的治疗策略。这一体系实现了整体与局部辨证的有机结合,完善了骨与关节退行性疾病的辨证论治方法,为临床诊疗提供了新的思路。Degenerative bone and joint diseases are common conditions in orthopedics.Based on the theories of Lingnan orthopedics school and SHIs'traumatology school,combined with modern medical understanding and clinical experience,this paper proposes a'tripartite diagnostic and therapeutic differentiation'system.This system refines the classification of tendon-bone patterns,summarizes the‘three pathogenic mechanisms'(tendon-bone imbalance,qi and blood disharmony,and concurrent pathogenic qi),establishes corresponding'three therapeutic principles'(balancing tendon-bone,harmonizing qi and blood,and eliminating concurrent pathogenic qi),and proposes a comprehensive traditional Chinese medicine treatment strategy that combines manual therapy,acupuncture,moxibustion,Chinese herbal medicine,and traditional exercises.This system achieves an integration of holistic and local pattern differentiation,improves the pattern differentiation and treatment method for degenerative bone and joint diseases,and provides new insights for clinical diagnosis and treatment.

关 键 词：骨与关节退行性疾病 筋骨病 病机 治则 辨证论治 三方辨证 

分 类 号：R24[医药卫生—中医临床基础]