试述“以筋为主”理论对于膝痹病防治的意义
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摘要
筋骨理论作为膝关节生理及病理发展的重要理论基础,其内外的稳定平衡是膝关节正常屈伸功能实现的关键。该文根据病因病机、治疗、预后将膝痹病分为未病、发病、病愈3个时期,通过剖析未病时期经筋御邪于外的内在机理,发病时期理筋正骨的治疗策略,病愈时期强筋宜动的防复思路这3个切入点,探讨"以筋为主"的理论在膝痹病不同阶段中所发挥的作用,最终达到标本同治、防治结合的目的,为临床防治本病提供新的思路依据。
The theory of tendons and bones is an important theoretical basis for the physiological and pathological development of the knee joint. The stable balance between inside and outside is the key to the normal flexion and extension function of the knee joint. According to the pathogenesis, treatment, and prognosis, knee disease is divided into three periods: no disease, onset, and recovery. By analyzing the internal mechanism of the disease during the period of disease, the treatment strategy of the disease and the bone is The three points of prevention and rejuvenation thoughts in the period of recovery are to explore the role of the theory of "mainly gluten-based" in different stages of knee rickets, and finally achieve the purpose of combining the same treatment with the treatment and prevention. Provide a new basis for the prevention and treatment of this disease.
The theory of tendons and bones is an important theoretical basis for the physiological and pathological development of the knee joint. The stable balance between inside and outside is the key to the normal flexion and extension function of the knee joint. According to the pathogenesis, treatment, and prognosis, knee disease is divided into three periods: no disease, onset, and recovery. By analyzing the internal mechanism of the disease during the period of disease, the treatment strategy of the disease and the bone is The three points of prevention and rejuvenation thoughts in the period of recovery are to explore the role of the theory of "mainly gluten-based" in different stages of knee rickets, and finally achieve the purpose of combining the same treatment with the treatment and prevention. Provide a new basis for the prevention and treatment of this disease.
引文
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[15]崔秀仁,王飞,赵勇,等.以《内经》卫气学说为指导浅议“气至而有效”[J].北京中医药,2016,35(7):677-678.
[16]仲跻申,张立,姚宏明.独活寄生汤联合塞来昔布治疗膝骨关节炎临观察[J].风湿病与关节炎,2016,5(1):11-13.
[17]王晓敏,赖震,包晓萍,等.中药熏蒸联合玻璃酸钠关节注射治疗老年膝骨性关节炎的疗效观察[J].中华物理医学与康复杂志,2017,39(1):152-153.
[18]靳发万,吴群,瞿群威,等.不同浓度臭氧关节腔注射对膝骨性关节炎患者IL-1和IL-6的影响[J].湖北中医药大学学报,2017,19(1):30-33.
[19]韩清民,王跃辉,黄旭东,等.膝骨关节炎从筋论治思路探讨[J].新中医,2009,41(1):5-6.
[20]张听雨,白玉龙.膝骨关节炎及其康复治疗[J].上海医药,2017,38(1):19-24.
[21]高文香,郝军.筋病理论指导下中医综合疗法治疗膝骨关节炎[J].中医正骨,2014,26(1):60-62.
[22]陈琦,孟晓耘,邢磊,等.养血柔肝法与补肾活血法治疗早期膝骨关节炎疗效对比分析[J].中医药临床杂志,2018(12):2305-2308.
[23]林志刚,蒋诗超,程艳彬,等.探讨《黄帝内经》“筋骨”理论对中医推拿的指导意义[J].中华中医药杂志,2016,31(7):2491-2493.
[24]庞坚,曹月龙,詹红生,等.骨关节炎的“筋”“骨”之辨[J].上海中医药大学学报,2012,26(1):29-30.
[25]吴绪平.针刀医学临床诊疗与操作规范[M].北京:中国中医药出版社,2012:62-67.
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[27]姜拯坤.“筋骨井重,骨正筋柔”思想在推拿手法中的体现[J].湖北中医杂志,2013,21(5):41-42.
[28]舒华,张世鹰,王笑莹,等.“动而生阳”理论对慢性心力衰竭患者运动康复影响分析[J].湖南中医药大学学报,2015,35(11):27-29.
[29]郭蕾.经筋与阳气[A].中国针灸学会经筋诊治专业委员会2010学术年会暨第二届中华经筋医学论坛论文集[C].中国针灸学会经筋诊治专业委员会,2010.
[30]清·叶天士著.临证指南医案[M].北京:人民卫生出版社,2006:112-113.
[31]齐越峰,陈福林.“骨折重治筋”学术思想介绍[J].北京中医药,2009,28:682-684.
[32]王钢,董宝强.经筋针刺+按摩拉伸+八式膝关节功能康复保健操治疗北方寒地早中期膝骨性关节炎(行痹/风痹、痛痹/寒痹)多中心随机平行对照研究[J].实用中医内科杂志,2018,32(6):61-65.
[2]李西海,刘献祥.基于筋骨理论探讨膝骨关节炎筋骨失衡的治疗策略[J].中华中医药杂志,2017,32(8):3344-3346.
[3]周纪平,杨永军,谭远超,等.筋骨并重、辨病诊治腰椎失稳性疾病的临床研究[J].中国中医骨伤科杂志,2014,22(4):14-17.
[4]马勇.中医筋伤学[M].北京:人民卫生出版社,2012:6.
[5]艾健,房敏,孙武权,等.“筋骨失衡,以筋为先”理论在膝关节病中的应用探讨[J].中华中医药杂志,2014,29(8):2404-2406.
[6]张亦廷,刘农虞.经筋针法治疗膝骨性关节炎的文献研究[J].中国针灸,2015,35(11):102-110.
[7]Bennell KL,Wrigley TV,Hunt MA,et al.Update on the roleofmusclein th genesis and management ofknee osteoarthritis[J].Rheum Dis Clin North Am,2013,39(1):145-176.
[8]王启才,高俊雄.经络的研究及临床应用[M].北京:中医古籍出版社,1998:110-116.
[9]张蓉,李峰,王常海,等.经筋理论在膝关节骨性关节炎发病机制及治疗中的作用[J].中国康复医学杂志,2007,22(7):644-646.
[10]王常海,李峰.针刀“动态平衡”理论在膝骨性关节炎中的探讨[J].中华中医药学刊,2007,25(1):73-75.
[11]刘涛,李平.经筋实质初探[J].中国针灸,2007,27(4):297-298.
[12]李义凯.对颈椎病病名的再认识[J].中国正骨,2014,26(6):403-405.
[13]赵明宇,廉杰,鲍铁周,等.平乐正骨“筋滞骨错”理论再析[J].中医正骨,2015,27(4):74-75,77.
[14]蒋科卫,温建民,焦权明,等.中西医对膝骨性关节炎的认识和治疗[J].中医正骨,2016,28(4):59-61.
[15]崔秀仁,王飞,赵勇,等.以《内经》卫气学说为指导浅议“气至而有效”[J].北京中医药,2016,35(7):677-678.
[16]仲跻申,张立,姚宏明.独活寄生汤联合塞来昔布治疗膝骨关节炎临观察[J].风湿病与关节炎,2016,5(1):11-13.
[17]王晓敏,赖震,包晓萍,等.中药熏蒸联合玻璃酸钠关节注射治疗老年膝骨性关节炎的疗效观察[J].中华物理医学与康复杂志,2017,39(1):152-153.
[18]靳发万,吴群,瞿群威,等.不同浓度臭氧关节腔注射对膝骨性关节炎患者IL-1和IL-6的影响[J].湖北中医药大学学报,2017,19(1):30-33.
[19]韩清民,王跃辉,黄旭东,等.膝骨关节炎从筋论治思路探讨[J].新中医,2009,41(1):5-6.
[20]张听雨,白玉龙.膝骨关节炎及其康复治疗[J].上海医药,2017,38(1):19-24.
[21]高文香,郝军.筋病理论指导下中医综合疗法治疗膝骨关节炎[J].中医正骨,2014,26(1):60-62.
[22]陈琦,孟晓耘,邢磊,等.养血柔肝法与补肾活血法治疗早期膝骨关节炎疗效对比分析[J].中医药临床杂志,2018(12):2305-2308.
[23]林志刚,蒋诗超,程艳彬,等.探讨《黄帝内经》“筋骨”理论对中医推拿的指导意义[J].中华中医药杂志,2016,31(7):2491-2493.
[24]庞坚,曹月龙,詹红生,等.骨关节炎的“筋”“骨”之辨[J].上海中医药大学学报,2012,26(1):29-30.
[25]吴绪平.针刀医学临床诊疗与操作规范[M].北京:中国中医药出版社,2012:62-67.
[26]刘东明.推拿手法学[M].北京:人民军医出版社,2011:18.
[27]姜拯坤.“筋骨井重,骨正筋柔”思想在推拿手法中的体现[J].湖北中医杂志,2013,21(5):41-42.
[28]舒华,张世鹰,王笑莹,等.“动而生阳”理论对慢性心力衰竭患者运动康复影响分析[J].湖南中医药大学学报,2015,35(11):27-29.
[29]郭蕾.经筋与阳气[A].中国针灸学会经筋诊治专业委员会2010学术年会暨第二届中华经筋医学论坛论文集[C].中国针灸学会经筋诊治专业委员会,2010.
[30]清·叶天士著.临证指南医案[M].北京:人民卫生出版社,2006:112-113.
[31]齐越峰,陈福林.“骨折重治筋”学术思想介绍[J].北京中医药,2009,28:682-684.
[32]王钢,董宝强.经筋针刺+按摩拉伸+八式膝关节功能康复保健操治疗北方寒地早中期膝骨性关节炎(行痹/风痹、痛痹/寒痹)多中心随机平行对照研究[J].实用中医内科杂志,2018,32(6):61-65.
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