基于肾虚血瘀病机探析膝痛康治疗膝骨关节炎机理
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摘要
膝骨关节炎是一种以膝关节软骨退变、关节内骨质增生、畸形为主的骨关节疾病。近年来在中老年人群中的发病率呈现增加的趋势,是临床常见病之一。临床治疗本病的方式有很多,其中包括内治法和外治法,不同的治疗方式有不同的特点。膝痛康是以古典经方鹿角丸为基础,根据临床经验总结出的治疗骨性关节炎的临床经验方。从祖国医学病因病机和现代医学发病机制出发,以肾虚血瘀病机为中心,探析膝痛康治疗膝骨关节炎的机理。
Knee osteoarthritis is a joint disease with degenerative changes,hyperplasia and malformation of articular cartilage. It is a common disease with increasing trend on clinic. There are many methods to treat it,including internal and external treatments with different characteristics. "Xitongkang"is a clinical prescription curing the disease based on classical prescription" Lujiaowan "from professors in the affiliated hospital of Liaoning University of traditional Chinese Medicine. Explored and analyzed the mechanism of treating knee osteoarthritis by Xitongkang starting from the pathogenesis both of traditional Chinese medicine and modern medicine,focusing on kidney deficiency and blood stasis pathogenesis.
Knee osteoarthritis is a joint disease with degenerative changes,hyperplasia and malformation of articular cartilage. It is a common disease with increasing trend on clinic. There are many methods to treat it,including internal and external treatments with different characteristics. "Xitongkang"is a clinical prescription curing the disease based on classical prescription" Lujiaowan "from professors in the affiliated hospital of Liaoning University of traditional Chinese Medicine. Explored and analyzed the mechanism of treating knee osteoarthritis by Xitongkang starting from the pathogenesis both of traditional Chinese medicine and modern medicine,focusing on kidney deficiency and blood stasis pathogenesis.
引文
[1]李宁,王拥军,施杞.膝骨性关节炎的中医药防治研究进展[J].中国中医骨伤科杂志,2013,21(5):62-65.
[2]李钊.冯新送教授从肾虚血瘀治疗骨性关节炎经验介绍[J].新中医,2011,43(11):152-153.
[3]郑筱萸.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002,5(1):349-353.
[4]杨青梅.膝骨关节炎的中医证候规律探究[D].北京:北京中医药大学,2013.
[5]申延清,刘风霞,曹红,等.膝骨关节炎患者的临床表现及相关影响因素[J].中国组织工程研究与临床康复,2011,15(9):1643-1646.
[6]Heidari,B,Hajian-Tilaki,K,Babaei,M.Determinants of pain in patients with symptomatic knee osteoarthritis[J].Caspian J Intern Med,2016,7(3):153-161.
[7]张金山.骨关节炎发病机制及中医药研究进展[J].河南中医,2011,32(2):201-203.
[8]Egloff C,Hügle T,Valderrabano V.Biomechanics and pathomechanisms of osteoarthritis[J].Swiss Med Wkly,2012,142:w13583.
[9]Yuan GH,Masuko-Hongo K,Kato T.Immunologic intervention in the pathogenesis of osteoarthritis[J].Arthritis Rheum,2003,48(3):602-611.
[10]Amiable N,Martel-Pelletier J,Lussier B,et al.Proteinaseactivated receptor-2 gene disruption limits the effect of osteoarthritis on cartilage in mice:a novel target in joint degradation[J].J Rheumatol,2011,38(5):911-920.
[11]辛爱芹.养血活血治法研究[D].济南:山东中医药大学,2012.
[12]李振华,赵文海,周秋丽.鹿茸多肽对抗骨关节炎软骨细胞氧化损伤作用的[J].中国骨伤,2011,24(3):245-248.
[13]修忠标,江陟郝,孙磊.鹿茸多肽干预膝骨性关节炎软骨细胞的增殖[J].中国组织工程研究与临床康复,2011,15(24):4448-4452.
[14]方芳,邹来勇,汤群珍.牛膝多糖对兔膝关节骨性关节炎修复的影响[J].河北中医,2014,36(5):749-755.
[15]乙军,刘守正,马小波,等.牛膝对塞来昔布治疗膝骨性关节炎的影响[J].中国中医骨伤科杂志,2013,21(10):45-46.
[16]Wang Y,Fang Y,Huang W,et al.Effect of sinomenine on cytokine expression of macrophages and synoviocytes in adjuvant arthritis rats[J].Ethnopharmacol,2005,98(1-2):37-43.
[17]李富明,徐攀峰.正清风痛宁注射液治疗膝关节骨性关节炎疗效观察[J].广西中医药,2013,36(2):6-8.
[18]刘良,李晓娟,王培训,等.青藤碱对人外周血单个核细胞IL-1β和IL-8细胞因子基因表达的影响[J].中国免疫学杂志,2002,18(4):241-244.
[19]梁秀军,孙同友,董文娟,等.穿山龙总皂苷对胶原性关节炎大鼠炎性细胞因子的影响[J].时珍国医国药,2013,24(3):522-524.
[20]于慧敏,聂英坤,王璟璐.白芍总苷对膝骨性关节炎患者血清一氧化氮和白细胞介素-1β水平的影响[J].哈尔滨医科大学学报,2007,41(5):455-459.
[21]颜秀芸.补益肝肾活血法治疗膝骨关节炎的临床研究[D].南京:南京中医药大学,2009.
[22]高文香,任汉阳,周颖,等.补肾法与活血法治疗兔膝骨性关节炎的病理形态学对比研究[J].中医正骨,2000,12(6):5.
[23]李佳.补益肝肾、活血通络法治疗膝骨性关节炎的临床研究[D].北京:北京中医药大学,2006.
[24]张师侥,关雪峰.中医外治法治疗膝骨性关节炎最新进展[J].中国骨质疏松杂志,2016,22(7):907-911.
[25]张宇鹏,刘元禄,关雪峰.刘元禄治疗膝骨性关节炎经验[J].辽宁中医杂志,2016,43(8):1607-1609.
[26]Goldring MB,Berenbaum F,The Regulation of Chondrocyte Function by Proinflammatory Mediators:Prostaglandins and Nitric Oxide[J].Clin Orthop Relat Res,2004(427 Suppl):S37-46.
[2]李钊.冯新送教授从肾虚血瘀治疗骨性关节炎经验介绍[J].新中医,2011,43(11):152-153.
[3]郑筱萸.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002,5(1):349-353.
[4]杨青梅.膝骨关节炎的中医证候规律探究[D].北京:北京中医药大学,2013.
[5]申延清,刘风霞,曹红,等.膝骨关节炎患者的临床表现及相关影响因素[J].中国组织工程研究与临床康复,2011,15(9):1643-1646.
[6]Heidari,B,Hajian-Tilaki,K,Babaei,M.Determinants of pain in patients with symptomatic knee osteoarthritis[J].Caspian J Intern Med,2016,7(3):153-161.
[7]张金山.骨关节炎发病机制及中医药研究进展[J].河南中医,2011,32(2):201-203.
[8]Egloff C,Hügle T,Valderrabano V.Biomechanics and pathomechanisms of osteoarthritis[J].Swiss Med Wkly,2012,142:w13583.
[9]Yuan GH,Masuko-Hongo K,Kato T.Immunologic intervention in the pathogenesis of osteoarthritis[J].Arthritis Rheum,2003,48(3):602-611.
[10]Amiable N,Martel-Pelletier J,Lussier B,et al.Proteinaseactivated receptor-2 gene disruption limits the effect of osteoarthritis on cartilage in mice:a novel target in joint degradation[J].J Rheumatol,2011,38(5):911-920.
[11]辛爱芹.养血活血治法研究[D].济南:山东中医药大学,2012.
[12]李振华,赵文海,周秋丽.鹿茸多肽对抗骨关节炎软骨细胞氧化损伤作用的[J].中国骨伤,2011,24(3):245-248.
[13]修忠标,江陟郝,孙磊.鹿茸多肽干预膝骨性关节炎软骨细胞的增殖[J].中国组织工程研究与临床康复,2011,15(24):4448-4452.
[14]方芳,邹来勇,汤群珍.牛膝多糖对兔膝关节骨性关节炎修复的影响[J].河北中医,2014,36(5):749-755.
[15]乙军,刘守正,马小波,等.牛膝对塞来昔布治疗膝骨性关节炎的影响[J].中国中医骨伤科杂志,2013,21(10):45-46.
[16]Wang Y,Fang Y,Huang W,et al.Effect of sinomenine on cytokine expression of macrophages and synoviocytes in adjuvant arthritis rats[J].Ethnopharmacol,2005,98(1-2):37-43.
[17]李富明,徐攀峰.正清风痛宁注射液治疗膝关节骨性关节炎疗效观察[J].广西中医药,2013,36(2):6-8.
[18]刘良,李晓娟,王培训,等.青藤碱对人外周血单个核细胞IL-1β和IL-8细胞因子基因表达的影响[J].中国免疫学杂志,2002,18(4):241-244.
[19]梁秀军,孙同友,董文娟,等.穿山龙总皂苷对胶原性关节炎大鼠炎性细胞因子的影响[J].时珍国医国药,2013,24(3):522-524.
[20]于慧敏,聂英坤,王璟璐.白芍总苷对膝骨性关节炎患者血清一氧化氮和白细胞介素-1β水平的影响[J].哈尔滨医科大学学报,2007,41(5):455-459.
[21]颜秀芸.补益肝肾活血法治疗膝骨关节炎的临床研究[D].南京:南京中医药大学,2009.
[22]高文香,任汉阳,周颖,等.补肾法与活血法治疗兔膝骨性关节炎的病理形态学对比研究[J].中医正骨,2000,12(6):5.
[23]李佳.补益肝肾、活血通络法治疗膝骨性关节炎的临床研究[D].北京:北京中医药大学,2006.
[24]张师侥,关雪峰.中医外治法治疗膝骨性关节炎最新进展[J].中国骨质疏松杂志,2016,22(7):907-911.
[25]张宇鹏,刘元禄,关雪峰.刘元禄治疗膝骨性关节炎经验[J].辽宁中医杂志,2016,43(8):1607-1609.
[26]Goldring MB,Berenbaum F,The Regulation of Chondrocyte Function by Proinflammatory Mediators:Prostaglandins and Nitric Oxide[J].Clin Orthop Relat Res,2004(427 Suppl):S37-46.