基于肝脾肾三脏的“脏-经-筋-穴”整体观合论膝骨关节炎
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摘要
膝骨关节炎属"骨痹"范畴,临床上常责之于肾,而笔者认为不仅可以从肾论治,故本文从横向的"肝脾肾"以及纵向的"脏-经-筋-穴"建立起整体观合论膝骨关节炎。首先,从"肾主骨""肝主筋""脾主四肢肌肉",而膝骨关节炎恰恰是下肢关于筋、骨、肉之病变,归其所属;其次,肝脾肾之脏、腑生理特性以及生理功能,对气、血、精、津、液的生成、传输亦可濡养筋、骨、肉;再次,在理论与临床常规操作的基础上,从肝胆脾胃肾膀胱六经之经穴均过"膝府",对膝关节有治疗作用;"膝为筋之府",从经筋理论来看肝脾肾三经筋亦与膝骨关节炎密切相关。因此,从肝脾之"脏-经-筋-穴"论治,体现了标本结合的治疗观以及纵横交织、由内而外的整体观。
Knee osteoarthritis belongs to the category of Gubi( 骨痹), and results from kidney. KOA not only can be treated from the kidney. Therefore, the horizontal of liver, spleen and kidney and vertical of Zang-Jing-Jin-Xue( 脏-经-筋-穴) were combined to treat knee osteoarthritis. First of all, kidney related to bone, liver related to tendons, and spleen related to main limb muscles. The above conformed with location of knee osteoarthritis. Second, physiology and physiological function of the liver, spleen and kidney were effective on gluten, bone, and meat. Third, based on the theoretical and clinical routine operations, the liver, gallbladder, spleen, stomach, kidney, bladder through the Xifu( 膝府) and have therapeutic effects on the knee joint. From the Jingjin therapy( 经筋理论), liver, spleen and kidney are also closely related to knee osteoarthritis. Therefore, Zang-Jing-Jin-Xue system shows wholism in TCM.
Knee osteoarthritis belongs to the category of Gubi( 骨痹), and results from kidney. KOA not only can be treated from the kidney. Therefore, the horizontal of liver, spleen and kidney and vertical of Zang-Jing-Jin-Xue( 脏-经-筋-穴) were combined to treat knee osteoarthritis. First of all, kidney related to bone, liver related to tendons, and spleen related to main limb muscles. The above conformed with location of knee osteoarthritis. Second, physiology and physiological function of the liver, spleen and kidney were effective on gluten, bone, and meat. Third, based on the theoretical and clinical routine operations, the liver, gallbladder, spleen, stomach, kidney, bladder through the Xifu( 膝府) and have therapeutic effects on the knee joint. From the Jingjin therapy( 经筋理论), liver, spleen and kidney are also closely related to knee osteoarthritis. Therefore, Zang-Jing-Jin-Xue system shows wholism in TCM.
引文
[1]何力,苏凤哲.膝骨关节炎中医治疗进展[J].中医临床研究,2014,6(21):95-97.
[2]刘淑刚,王金榜.现代中医对膝骨关节炎的认识[J].现代中西医结合杂志,2013,22(13):1473-1475.
[3]李莉,田甜,应森林.痛风性关节炎的中医药治疗进展[J].天津中医药大学学报,2013,32(4):253-255.
[4]肖林榕,郑红.明清医家论治骨痹(骨关节炎)临床理论的发展[J].中医文献杂志,2003,3(2):10-12.
[5]杨会军,李兆福,彭江云,等.膝骨关节炎中医药治疗研究概况[J].辽宁中医药大学学报,2013,15(8):129-130.
[6]师东良,王宁华,谢斌.膝骨关节炎患者股内侧肌、股直肌和股外侧肌间的协调性[J].中国康复理论与实践,2010,16(5):473-475.
[7]安丙辰,郑洁皎,沈利岩.膝骨关节炎与膝关节伸、屈肌群肌力的相关性研究[J].医用生物力学,2015,30(2):174-176.
[8]黄彬洋,庞日朝,王文春,等.核心肌群渐进式训练模式对膝骨关节炎患者功能改善的临床观察[J].西南军医,2016,18(5):426-427.
[9]熊德启,黄彬洋,刘晓瑞,等.基于脾肉系统的核心肌群肌力训练结合电针对膝骨关节炎患者的肌力改善临床观察[J].中医外治杂志,2016,25(4):3-5.
[10]黄彬洋.基于运动链理论的核心肌群渐进式肌力训练治疗膝骨关节炎的社区方案研究[D].成都:成都中医药大学,2016:32-35.
[11]范志勇,吴栓,谢兵,等.基于“筋为骨用”探讨“舒筋”手法治疗膝骨关节炎的力学机制[J].上海中医药大学学报,2014,28(3):15-17.
[12]陈永韶,冯学烽,邹伟民,等.膝骨关节炎经筋与影像学的相关性探讨[J].广州中医药大学学报,2014,31(4):526-528.
[13]乐意,金荣疆,阳杨,等.从下肢生物力学来解析膝骨关节炎[J].中国康复理论与实践,2013,19(6):505-508.
[14]丁站新,宋雅芳,刘友章.肝脾相关理论的阐发探微[J].福建中医药,2013,44(3):3-5.
[15]沈丽果,马佐英,孟静岩,等.浅析《症因脉治》中脾主运化理论[J].天津中医药大学学报,2014,34(2):73-76.
[16]田策,鲁娟,曹良东.近5年来针灸治疗膝骨性关节炎选穴规律的分析[J].现代中医药,2013,33(3):70-72.
[17]张鹤,赵百孝,宋艳.近10年来灸法治疗膝骨关节炎的现代临床研究及选穴规律的分析[J].中医药信息,2015,32(2):118-120.
[18]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.
[19]周达,马涛,朱浩.综合治法对膝骨关节炎疗效分析[J].中医临床研究,2012,4(14):19-20.
[20]管傲然,管薇薇,丁丽玲,等.十二经筋理论的临床运用[J].云南中医中药杂志,2014,35(8):53-54.
[21]黄木全.膝关节骨性关节炎各期经筋辩证及相关证素研究[D].北京:北京中医药大学,2012:55-58.
[22]秦伟凯.从经筋论治膝骨关节炎性疼痛的临床随机对照研究[D].北京:中国中医科学院,2012:46-56.
[23]庞坚,石印玉,曹月龙.膝骨关节炎中医观的再认识[J].上海中医药大学学报,2011,25(1):26-28.
[24]丁站新,宋雅芳,刘友章.肝脾相关理论的经典溯源[J].辽宁中医药,2013,40(7):1344-1345.
[25]黄艳芳,徐明艳.温针透刺联合康复治疗老年性膝骨关节炎临床研究[J].中医临床研究,2014,6(14):33-34.
[2]刘淑刚,王金榜.现代中医对膝骨关节炎的认识[J].现代中西医结合杂志,2013,22(13):1473-1475.
[3]李莉,田甜,应森林.痛风性关节炎的中医药治疗进展[J].天津中医药大学学报,2013,32(4):253-255.
[4]肖林榕,郑红.明清医家论治骨痹(骨关节炎)临床理论的发展[J].中医文献杂志,2003,3(2):10-12.
[5]杨会军,李兆福,彭江云,等.膝骨关节炎中医药治疗研究概况[J].辽宁中医药大学学报,2013,15(8):129-130.
[6]师东良,王宁华,谢斌.膝骨关节炎患者股内侧肌、股直肌和股外侧肌间的协调性[J].中国康复理论与实践,2010,16(5):473-475.
[7]安丙辰,郑洁皎,沈利岩.膝骨关节炎与膝关节伸、屈肌群肌力的相关性研究[J].医用生物力学,2015,30(2):174-176.
[8]黄彬洋,庞日朝,王文春,等.核心肌群渐进式训练模式对膝骨关节炎患者功能改善的临床观察[J].西南军医,2016,18(5):426-427.
[9]熊德启,黄彬洋,刘晓瑞,等.基于脾肉系统的核心肌群肌力训练结合电针对膝骨关节炎患者的肌力改善临床观察[J].中医外治杂志,2016,25(4):3-5.
[10]黄彬洋.基于运动链理论的核心肌群渐进式肌力训练治疗膝骨关节炎的社区方案研究[D].成都:成都中医药大学,2016:32-35.
[11]范志勇,吴栓,谢兵,等.基于“筋为骨用”探讨“舒筋”手法治疗膝骨关节炎的力学机制[J].上海中医药大学学报,2014,28(3):15-17.
[12]陈永韶,冯学烽,邹伟民,等.膝骨关节炎经筋与影像学的相关性探讨[J].广州中医药大学学报,2014,31(4):526-528.
[13]乐意,金荣疆,阳杨,等.从下肢生物力学来解析膝骨关节炎[J].中国康复理论与实践,2013,19(6):505-508.
[14]丁站新,宋雅芳,刘友章.肝脾相关理论的阐发探微[J].福建中医药,2013,44(3):3-5.
[15]沈丽果,马佐英,孟静岩,等.浅析《症因脉治》中脾主运化理论[J].天津中医药大学学报,2014,34(2):73-76.
[16]田策,鲁娟,曹良东.近5年来针灸治疗膝骨性关节炎选穴规律的分析[J].现代中医药,2013,33(3):70-72.
[17]张鹤,赵百孝,宋艳.近10年来灸法治疗膝骨关节炎的现代临床研究及选穴规律的分析[J].中医药信息,2015,32(2):118-120.
[18]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.
[19]周达,马涛,朱浩.综合治法对膝骨关节炎疗效分析[J].中医临床研究,2012,4(14):19-20.
[20]管傲然,管薇薇,丁丽玲,等.十二经筋理论的临床运用[J].云南中医中药杂志,2014,35(8):53-54.
[21]黄木全.膝关节骨性关节炎各期经筋辩证及相关证素研究[D].北京:北京中医药大学,2012:55-58.
[22]秦伟凯.从经筋论治膝骨关节炎性疼痛的临床随机对照研究[D].北京:中国中医科学院,2012:46-56.
[23]庞坚,石印玉,曹月龙.膝骨关节炎中医观的再认识[J].上海中医药大学学报,2011,25(1):26-28.
[24]丁站新,宋雅芳,刘友章.肝脾相关理论的经典溯源[J].辽宁中医药,2013,40(7):1344-1345.
[25]黄艳芳,徐明艳.温针透刺联合康复治疗老年性膝骨关节炎临床研究[J].中医临床研究,2014,6(14):33-34.