刘德玉从虚、瘀论治膝骨性关节炎
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摘要
刘德玉教授认为,膝关节骨性关节炎(KOA)的中医病因病机特点是肝肾亏虚与瘀血痹阻并存,虚致瘀,瘀又加重虚,两者相互作用,形成恶性循环。本病属于本虚标实,肝肾亏虚为其发病的根本,瘀血阻痹为其发病的关键。肝肾亏虚,肾精虚弱,无力化肝血,致使血不荣筋骨;气血不足,运行不畅,致使瘀血阻滞;不荣则痛、不通则痛致使关节疼痛、筋脉拘挛、屈伸不利而发病。治疗当以补益肝肾、活血化瘀、通络止痛为原则,从而达到标本兼治的目的,也体现了急则治其标、缓则治其本的学术思想和其三位一体的诊疗思想。
Professor LIU Deyu believes that the TCM etiology and pathogenesis of knee osteoarthritis(KOA) is characterized by deficiency of liver and kidney and stagnation of blood stasis,deficiency leads to blood stasis,blood stasis aggravates deficiency,they interact each other to form a vicious circle.The disease belongs to the root vacuity and arthralgia,the deficiency of the liver and kidney is the basis of its onset,and the stagnation of blood stasis is the key to its onset.Deficiency of liver and kidney and weakness of kidney essence lead to inability to change liver blood,resulting in blood can not nourish bones and muscles.Insufficiency of qi and blood and sluggish operation lead to stagnation of blood stasis.Blood-insufficiency and obstruction lead to pain,spastic muscles and inflexible flexion and extension eventually lead to morbidity.Treatment should be based on the principle of invigorating the liver and kidney,activating blood circulation to dissipate blood stasis,dredging collaterals and relieving pain,in order to achieve the purpose of treating both the root and branch,it also embodies the academic thought of "In urgent conditions,treat the branch.In moderate conditions,treat the root ",and its Trinity diagnosis and treatment thought.
Professor LIU Deyu believes that the TCM etiology and pathogenesis of knee osteoarthritis(KOA) is characterized by deficiency of liver and kidney and stagnation of blood stasis,deficiency leads to blood stasis,blood stasis aggravates deficiency,they interact each other to form a vicious circle.The disease belongs to the root vacuity and arthralgia,the deficiency of the liver and kidney is the basis of its onset,and the stagnation of blood stasis is the key to its onset.Deficiency of liver and kidney and weakness of kidney essence lead to inability to change liver blood,resulting in blood can not nourish bones and muscles.Insufficiency of qi and blood and sluggish operation lead to stagnation of blood stasis.Blood-insufficiency and obstruction lead to pain,spastic muscles and inflexible flexion and extension eventually lead to morbidity.Treatment should be based on the principle of invigorating the liver and kidney,activating blood circulation to dissipate blood stasis,dredging collaterals and relieving pain,in order to achieve the purpose of treating both the root and branch,it also embodies the academic thought of "In urgent conditions,treat the branch.In moderate conditions,treat the root ",and its Trinity diagnosis and treatment thought.
引文
[1]袁普卫,吕水英,刘德玉,等.辨病、辨证与辨位“三位一体”诊疗模式在膝痹病诊断中的意义[C]//中华中医药学会骨伤科分会学术年会论文集,南京:2012.
[2]贾伟.膝关节骨性关节炎中医治疗进展[J].河北中医,2015,37(11):1743-1746.
[3]慕向前,赵继荣,邓强,等.中医补肾壮骨强筋法治疗膝关节骨性关节炎的研究进展[J].中医临床研究,2015,7(36):70-72.
[4]苏睿.膝关节骨性关节炎治疗进展研究[J].中医临床研究,2016,8(2):145-146.
[5]楚向东,郝阳泉.刘德玉教授从虚论治膝骨性关节炎经验[J].光明中医,2012,27(2):232-233.
[6]高世超,殷海波,刘宏潇,等.骨关节炎从瘀论治思路探讨[J].中国中医药信息杂志,2015,32(4):98-99.
[7]成海燕,于建春,李国民,等.衰老-血瘀相关研究概况[J].辽宁中医杂志,2010,37(9):1660-1663.
[8]曹玉举,李士谨,娄伯恩,等.痰瘀致痹机制及辨证论治[J].中医研究,2010,23(11):64-68.
[9]郝阳泉,楚向东.刘德玉教授治疗膝骨性关节炎的整体诊治策略[J].陕西中医学院学报,2011,34(6):19-22.
[10]郝阳泉.刘德玉主任医师治疗膝骨性关节炎(膝痹病)学术思想及临床经验研究[D].北京:中国中医科学院,2012.
[11]高世超,殷海波,刘宏潇,等.从肾虚血瘀论治骨关节炎的临证体会[J].世界中医药,2014,4(10):1328-1330.
[12]潘细贵,修忠标,江陟郝,等.补肾活血法治疗KOA机制的研究进展[J].江西中医药,2009,40(12):76-78.
[13]许学猛,王羽丰,邓晋丰,等.补肾活血胶囊影响兔膝关节退变性疾病骨内压变化的实验研究[J].中国中医骨伤科杂志,2001,9(4):24-27.
[14]孟魏魏,唐学典.防己黄芪汤加味治疗膝骨关节炎56例临床研究[J].江苏中医药,2015,46(8):47-48.
[15]刘发元,党传鹏,翁霞萍,等.牛膝引药下行靶向调节骨关节炎软骨退变的机制探讨[J].风湿病与关节炎,2014(6):46-48.
[16]高宁阳,庞坚,曹月龙,等.中药治疗骨关节炎的处方用药研究[J].中国中医骨伤科杂志,2008,16(8):6-9.
[2]贾伟.膝关节骨性关节炎中医治疗进展[J].河北中医,2015,37(11):1743-1746.
[3]慕向前,赵继荣,邓强,等.中医补肾壮骨强筋法治疗膝关节骨性关节炎的研究进展[J].中医临床研究,2015,7(36):70-72.
[4]苏睿.膝关节骨性关节炎治疗进展研究[J].中医临床研究,2016,8(2):145-146.
[5]楚向东,郝阳泉.刘德玉教授从虚论治膝骨性关节炎经验[J].光明中医,2012,27(2):232-233.
[6]高世超,殷海波,刘宏潇,等.骨关节炎从瘀论治思路探讨[J].中国中医药信息杂志,2015,32(4):98-99.
[7]成海燕,于建春,李国民,等.衰老-血瘀相关研究概况[J].辽宁中医杂志,2010,37(9):1660-1663.
[8]曹玉举,李士谨,娄伯恩,等.痰瘀致痹机制及辨证论治[J].中医研究,2010,23(11):64-68.
[9]郝阳泉,楚向东.刘德玉教授治疗膝骨性关节炎的整体诊治策略[J].陕西中医学院学报,2011,34(6):19-22.
[10]郝阳泉.刘德玉主任医师治疗膝骨性关节炎(膝痹病)学术思想及临床经验研究[D].北京:中国中医科学院,2012.
[11]高世超,殷海波,刘宏潇,等.从肾虚血瘀论治骨关节炎的临证体会[J].世界中医药,2014,4(10):1328-1330.
[12]潘细贵,修忠标,江陟郝,等.补肾活血法治疗KOA机制的研究进展[J].江西中医药,2009,40(12):76-78.
[13]许学猛,王羽丰,邓晋丰,等.补肾活血胶囊影响兔膝关节退变性疾病骨内压变化的实验研究[J].中国中医骨伤科杂志,2001,9(4):24-27.
[14]孟魏魏,唐学典.防己黄芪汤加味治疗膝骨关节炎56例临床研究[J].江苏中医药,2015,46(8):47-48.
[15]刘发元,党传鹏,翁霞萍,等.牛膝引药下行靶向调节骨关节炎软骨退变的机制探讨[J].风湿病与关节炎,2014(6):46-48.
[16]高宁阳,庞坚,曹月龙,等.中药治疗骨关节炎的处方用药研究[J].中国中医骨伤科杂志,2008,16(8):6-9.