基于“筋出槽,骨错缝”探析退行性腰椎滑脱症的辨治策略  

Analyzing the diagnosis and treatment strategy of degenerative lumbar spondylolisthesis based on the principle of‘tendon out of groove,bone misalignment’

作　　者：朱紫墨 仲东生 汪利合[3] 麻蒙凡 ZHU Zimo;ZHONG Dongsheng;WANG Lihe;MA Mengfan(Henan University of Chinese Medicine,Zhengzhou 450046,China;Beijing Emergency Medical Center,Beijing 100031,China;The First Affiliated Hospital of Henan University of CM,Zhengzhou 450003,China)

机构地区：[1]河南中医药大学,郑州450046 [2]北京急救中心,北京100031 [3]河南中医药大学第一附属医院,郑州450003

出　　处：《中华中医药杂志》2025年第2期501-504,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：河南省中医药拔尖人才培养项目(No.豫中医科教[2018]35号)。

摘　　要：退行性腰椎滑脱症作为骨伤科常见疾病,其发病率高,容易反复发作,并且在临床治疗中难以彻底根治。脊柱为“筋出槽,骨错缝”的好发部位,结合退行性腰椎滑脱症的特点及临床表现,认为“筋出槽,骨错缝”是其发病的病理状态,而筋骨气血失和、肝肾亏虚、经脉瘀滞为其基本病机,并结合临床诊疗经验,初步提出了“和、补、通”三法辨治退行性腰椎滑脱症。其中“和”为气血调和、筋骨合和,“补”为补益肝肾、培补本元,“通”为通经活络、以复其形。从“和、补、通”三法认识“筋出槽,骨错缝”并指导退行性腰椎滑脱症的综合治疗,为临床诊疗退行性腰椎滑脱症提供了依据。Degenerative lumbar spondylolisthesis,as a common orthopedic disease,has a high incidence rate,is prone to recurrence,and is difficult to be completely cured in clinical treatment.The spine is the most common site of'tendon out of groove,bone misalignment'.Combined with the characteristics and clinical manifestations of degenerative lumbar spondylolisthesis,it is believed that'tendon out of groove,bone misalignment'is the pathological state of its onset,and that loss of harmony between tendon and bone,deficiency of liver and kidney,and stagnation of meridians and veins are the basic pathogenesis of the disease.Combined with the clinical experience,we initially propose the three methods of‘harmony.nourishing,and dredging'for the treatment of degenerative lumbar spondylolisthesis,in which harmony'is to harmonize the qi and blood,and the muscles and bones,and'nourishing'is to replenish the liver and kidneys,and cultivate the essence,and the'dredging'is to activate the meridians and collaterals,and to restore the shape.From the three methods of‘harmony,nourishing,and dredging',we can recognize'tendon out of groove,bone misalignment'and guide the comprehensive treatment of degenerative lumbar spondylolisthesis,which provides the basis for the clinical diagnosis and treatment of degenerative lumbar spondylolisthesis.

关 键 词：筋出槽 骨错缝 退行性腰椎滑脱症 和法 补法 通法 

分 类 号：R274.9[医药卫生—中西医结合]