1.上海中医药大学附属第七人民医院康复医学科(上海 200137)
2.上海交通大学附属新华医院中医科(上海 200092)
3.上海中医药大学康复医学院(上海 201203)
4.上海中医药大学附属光华医院脊柱外科(上海 200336)
殷磊,男,硕士,主治医师,主要从事骨与关节疾病的中西医结合诊疗及康复工作;*为共同第一作者
吴绪波,副教授,硕士研究生导师;E-mail:wuxubo320@163.com
褚立希,教授,博士研究生导师;E-mail:chulixi2@126.com
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殷磊,马碧涛,蒋黎明,等.褚立希论治膝骨关节炎学术经验撷菁[J].上海中医药杂志,2023,57(3):30-33.
YIN Lei,MA Bitao,JIANG Liming,et al.Chu Lixi’s academic experience in treatment of knee osteoarthritis[J].Shanghai Journal of Traditional Chinese Medicine,2023,57(3):30-33.
殷磊,马碧涛,蒋黎明,等.褚立希论治膝骨关节炎学术经验撷菁[J].上海中医药杂志,2023,57(3):30-33. DOI: 10.16305/j.1007-1334.2023.2207041.
YIN Lei,MA Bitao,JIANG Liming,et al.Chu Lixi’s academic experience in treatment of knee osteoarthritis[J].Shanghai Journal of Traditional Chinese Medicine,2023,57(3):30-33. DOI: 10.16305/j.1007-1334.2023.2207041.
介绍禇立希教授治疗膝骨关节炎的临床经验。认为本病属“早痹后痿”“标痹本痿”,病机特点为“由痹致痿,痹痿共存,痹痿互损”。治疗本病注重辨证论治与分期论治相结合,整体与局部兼顾、标本兼顾、痹痿共治。同时,重视中药口服结合外治法,“内外同治”“一方三用”。另外,还重视“筋骨失衡”的内因,治疗中主张“筋骨并重”,推崇分期伤科手法治疗联合功能训练,“医康一体”治疗。并附临床验案1则。
The clinical experience of Professor Chu Lixi in treating knee osteoarthritis (KOA) is introduced in this article. It is considered that “arthralgia comes earlier than flaccidity” in the development of KOA, with “arthralgia as the manifestation and flaccidity as the root”. The pathogenesis is characterized by “arthralgia developing into flaccidity, coexistence of arthralgia and flaccidity, and mutual impairment between arthralgia and flaccidity”. Professor Chu emphasizes the importance of combining syndrome differentiation-based treatment and stage differentiation-based treatment, giving considerations to the combined treatment of the whole and the local, the manifestations and the root, as well as arthralgia and flaccidity. Meanwhile, the combined use of oral and external treatment of traditional Chinese medicine is highly valued. Therefore, the principles of “combined internal and external treatment” and “one prescription for three uses” are fully practiced. In view of the internal pathogenesis of “imbalance of sinews and bones”, Professor Chu puts “equal emphasis on the treatment of sinews and bones”, advocating combined use of staged orthopaedic manipulative therapies and functional training to achieve “integrated medical treatment and rehabilitation”. One proven case is presented.
膝骨关节炎痹证痿证筋骨失衡中医药疗法康复临床经验
knee osteoarthritisarthralgiaflaccidityimbalance of sinews and bonestraditional Chinese medicine therapyrehabilitationclinical experience
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马碧涛,禇立希,金立伦,等. 手法联合盐酸氨基葡萄糖治疗膝骨关节炎临床观察[J]. 安徽中医药大学学报,2019, 38(1): 48-51.
库秀娟,杨松滨,禇立希,等. 电针和推拿手法治疗膝骨性关节炎临床疗效比较研究[J]. 上海中医药杂志,2009, 43(8): 19-21.
查建林,杨松滨,禇立希,等. 理筋手法结合功能锻炼对膝骨性关节炎患者步态的改善作用[J]. 上海中医药杂志,2011, 45(2): 35-37.
姜淑云,禇立希,查建林,等. 理筋手法结合功能训练治疗膝骨关节炎的步态特征研究[J]. 中国康复医学杂志,2011, 26(11): 1056-1058.
蒋黎明,张增乔,冯伟. 髌下脂肪垫松解手法治疗膝骨关节炎的临床疗效[J]. 中国老年学杂志,2020, 40(1): 342-344.
蒋黎明,于小明,丁余武,等. 体外冲击波疗法联合站桩训练治疗膝骨关节炎的临床疗效[J]. 广西医学,2022, 44(16): 1847-1850.
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