张建华以膝痹舒联合丁锷外用方治疗膝骨关节炎经验  

Zhang Jianhua's Experience in Treating Knee Osteoarthritis with Xi Bishu and Ding E's External Prescription

作　　者：王玉文 朱民顺 梁龙 张建华[2] Wang Yuwen;Zhu Minshun;Liang Long;Zhang Jianhua(The First Clinical School of Anhui University of Traditional Chinese Medicine,Hefei,230031,China;The First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei,230031,China)

机构地区：[1]安徽中医药大学第一临床医学院,安徽合肥230031 [2]安徽中医药大学第一附属医院,安徽合肥230031

出　　处：《成都中医药大学学报》2025年第2期65-69,共5页Journal of Chengdu University of Traditional Chinese Medicine

基　　金：安徽省自然科学基金项目(2308085QH292);安徽中医药大学科研基金项目(2022ZJXK04);安徽省名中医及基层名中医工作室建设项目(中发展2022年5号)。

摘　　要：膝骨关节炎(knee osteoarthritis,KOA)是因关节软骨退变而产生一系列不良症状的骨关节疾病。张建华认为KOA的病机是以肝脾肾虚损为本,风寒湿邪侵袭和瘀阻经脉为标,总属本虚标实,治疗时应该标本兼顾。临床上因该病就诊的患者病情多处于风寒湿侵袭的急性疼痛期,外邪侵袭虽由脏腑虚损所致,但本着“急则治其标”的原则,在用药治疗时应先以祛邪为主,然后稍佐温补肝肾气血之品。另外,张建华用药治疗KOA时,注重补火助阳,提升脏腑阳气以驱散和抵御外邪,再用外敷之消瘀接骨散,内外并举,使风寒湿邪无处遁形。除用药治疗外,张建华主张防治并重,嘱KOA患者做功法锻炼,提升下肢肌肉力量,延缓膝关节退变。The knee osteoarthritis(KOA)is a disease that produces a series of adverse symptoms due to degeneration of joint cartilage.Zhang Jianhua believes that the pathogenesis of knee osteoarthritis’root cause is deficiency of the Liver,Spleen and Kidney.Wind,Cold and Dampness attacking and stasis of blood as manifestations.In general,it’s a deficiency of the internal organs and the external etiological factors are present.So the treatment should take into account both the essence and the manifestations.Clinically,patients with this disease are mostly in the acute pain stage of Wind-Cold-Dampness attack.Although Wind-Cold-Dampness attacks are caused by the deficiency of internal organs,but in line with the principle of“relieving the secondary symptoms first in treating acute disease”.When treating with medication,the main focus should be on dispelling the exogenous Evil first,and then add a small amount of warm Liver and Kidney Qi and Blood products.In addition,when Zhang Jianhua used medicine to treat KOA,he paid attention to tonifying Fire and helping Yang,promoting Yang Qi of Zangfu organs to disperse and resist exogenous Evil,and then used Xiaoyu Jiegu powder for external application,both inside and outside,so that Wind-Cold-Dampness Evil had no place to hide.In addition to medicine treatment,Zhang Jianhua advocates equal attention to prevention and treatment,and urges KOA patients to do exercises to improve lower limb muscle strength and delay knee joint degeneration.

关 键 词：膝骨关节炎 张建华 丁锷 膝痹舒 消瘀接骨散 标本兼顾 经验 

分 类 号：R249[医药卫生—中医临床基础] R681.8[医药卫生—中医学]