“骨、筋、肌肉”三位一体对膝骨关节炎的防治作用
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摘要
膝骨关节炎(Knee Osteoarthritis,KOA),是以膝关节软骨的变性、破坏关节周围骨质增生为特征的慢性关节病,临床表现为膝关节局部疼痛、晨僵、肿胀、活动受限、严重者可出现关节的畸形,并最终可导致残疾的风险,据其证候特点属于中医学"膝痹病"、"骨痹"、"痹证"等范畴,该病核心病机为本痿标痹,以肝肾亏虚、筋骨失养为本,以腠理空虚易感风寒湿邪、瘀血阻滞筋络为标,主要病位在软骨,但其疾病的发生、发展应涵盖骨、筋、肌肉三者之间的相互作用。故笔者分别就对KOA"骨、筋、肌肉"三者关系认识、不同发病因素对"骨、筋、肌肉"的影响,以及在KOA临床治疗中的对"骨、筋、肌肉"的调节三方面说明"骨、筋、肌肉"与KOA的发生、发展、治疗、转归等密切关系,为"骨、筋、肌肉"三位一体理论在指导认识KOA的发生、发展、治疗、转归的理论价值和实际应用价值。
Knee osteoarthritis(KOA) is a chronic joint disease characterized by degeneration of the knee joint cartilage and destruction of the surrounding bone. The main clinical expressions of KOA are knee joint pain,swelling stiffness and limitation of activity,even the deformity of joints and the risk of disability. According to the characteristics of the syndrome,KOA belongs to knee paralysis disease,bone paralysis,and arthromyodynia in traditional Chinese medicine(TCM). The core pathogenesis of KOA is flaccidity inside and obstruction outside. Deficiency of the liver and kidney and malnutrition of the tendon and bone happens inside. Invasion of wind,cold,and wet,blood and phlegm stasis which obstruct collaterals happen outside. The main location of the disease is at the cartilage,but the occurrence and development of the disease involve the interaction among the tendon,bone,and muscle. This review summarizes the literature addressing the interaction among the tendon,bone,and muscle,and the occurrence,development,treatment,and prognosis of KOA from three aspects: the perspective of the interaction among the tendon,bone,and muscle,the effect of different pathogenic factors on the tendon,bones,and muscle,the regulation of the tendon,bone,and muscle in the clinical trials of KOA,providing theoretical and practical value to guide the knowledge of the occurrence,development,treatment and prognosis of KOA from the trinity theory.
Knee osteoarthritis(KOA) is a chronic joint disease characterized by degeneration of the knee joint cartilage and destruction of the surrounding bone. The main clinical expressions of KOA are knee joint pain,swelling stiffness and limitation of activity,even the deformity of joints and the risk of disability. According to the characteristics of the syndrome,KOA belongs to knee paralysis disease,bone paralysis,and arthromyodynia in traditional Chinese medicine(TCM). The core pathogenesis of KOA is flaccidity inside and obstruction outside. Deficiency of the liver and kidney and malnutrition of the tendon and bone happens inside. Invasion of wind,cold,and wet,blood and phlegm stasis which obstruct collaterals happen outside. The main location of the disease is at the cartilage,but the occurrence and development of the disease involve the interaction among the tendon,bone,and muscle. This review summarizes the literature addressing the interaction among the tendon,bone,and muscle,and the occurrence,development,treatment,and prognosis of KOA from three aspects: the perspective of the interaction among the tendon,bone,and muscle,the effect of different pathogenic factors on the tendon,bones,and muscle,the regulation of the tendon,bone,and muscle in the clinical trials of KOA,providing theoretical and practical value to guide the knowledge of the occurrence,development,treatment and prognosis of KOA from the trinity theory.
引文
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