叶海教授治疗老年性膝骨关节炎经验撷萃  

YE Hai's Experience in Treating Senile Knee Osteoarthritis

作　　者：张辽 邓颖萍 叶海 ZHANG Liao;DENG Yingping;YE Hai(Ningbo Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University,Ningbo 315000,Zhejiang,China)

机构地区：[1]浙江中医药大学附属宁波中医院,浙江宁波315000

出　　处：《中华中医药学刊》2025年第3期112-115,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：国家中医药管理局全国名老中医药专家传承工作室项目(国中医药人教发[2016]42号);浙江省中医药科技计划项目(2018ZB119,2024ZL144);浙江省“十三五”中医药重点专科建设项目(浙卫办中医[2019]1号);宁波市自然科学基金项目(2021J300);宁波市医学重点学科建设计划项目(2022-Z09);宁波市卫生健康青年技术骨干人才培养专项(甬卫发[2020]95号);宁波市名中医药专家学术经验继承项目(甬卫办中医[2020]150号)。

摘　　要：介绍叶海教授治疗膝骨关节炎(Knee Osteoarthritis,KOA)的临证经验。KOA是一类高患病率、高致残率的疾病,临床多以膝关节肿痛、僵硬、活动不利以及功能障碍等为主要表现,严重者可出现关节畸形,随着病程延长及病情加重可导致肌肉萎缩,甚至残疾。KOA属于传统医学中“膝痹”“鹤膝风”等疾病范畴,其病因多由于年老体衰、气血不足、脏腑功能失调,导致寒湿内生或外感风寒湿邪,气血运行不畅,阻滞经络,不通则痛,发为本病;病情迁延不愈,反复发作,久病入络,气血不能濡养筋骨经络,则肌肉不充,筋骨不坚,髓海失养,髓枯骨痿。叶海教授认为老年KOA以“先天不足、后天失调、肝郁气滞、寒湿痰瘀”为关键病机和病理特点,相互影响、互为因果,临床患者往往因虚致瘀、因虚生痰、寒湿瘀阻、痰瘀互结。叶海教授擅长采用平补脾肾、疏肝理气、散寒除湿、化痰逐瘀的治疗原则治疗本病,可收获良好的临床效果。This article introduced Professor YE Hai's clinical experience in treating knee osteoarthritis(KOA).KOA is a dis-ease with high incidence and disability rate.Clinically,it is mainly characterized by knee joint swelling,stiffness,poor mobility and functional impairment.Severe cases may result in joint deformities,and as the disease progresses and worsens,it can lead to muscle atrophy and even disability.KOA belongs to the category of“knee Bi syndrome”and“Hexifeng”in traditional Chinese medicine.Its cause is mostly due to old age,insufficient Qi and blood,and dysfunction of Zang-organs,leading to endogenous cold and dampness or external wind cold and dampness.If the circulation of Qi and blood is not smooth,blocking the meridians and causing pain,and then resulting in this disease.The persisting condition,recurrent attacks,prolonged illness entering the me-ridians,and Qi and blood failing to nourish the muscles and bones,could make the muscles,bones and tendons lack of nourish-ment,and the marrow will lose nourishment.Professor YE Hai believes that the key pathogenesis and pathological characteristics of KOA in the elderly are“congenital deficiency,acquired disorder,liver-Qi stagnation,cold-dampness phlegm and blood sta-sis”,which affect each other.Clinical patients often develop blood stasis due to deficiency,phlegm due to deficiency,cold-dampness and blood stasis and accumulation of phlegm-blood stasis.Professor YE Hai is skilled in using the treatment princi-ples of tonifying spleen and kidney,soothing liver and regulating Qi,dispelling cold and dampness,and resolving phlegm and blood stasis to treat this disease,which can achieve good clinical results.

关 键 词：膝骨关节炎 老年 叶海教授 名医经验 

分 类 号：R274[医药卫生—中医骨伤科学]