近10年广东中医骨伤手法治疗膝骨关节炎研究进展

Research Progress in the Treatment of Knee Osteoarthritis by Chinese Medicine Manipulation for Orthopedic and Traumatic Diseases in Guangdong in Recent 10 Years

目的:分析归纳岭南地区以广东为代表的近10年中医骨伤手法治疗膝骨关节炎(KOA)的文献,探讨其证治特色。方法:通过查阅中医药类教材《中医筋伤学》《中医骨病学》,检索中国知网、万方数据库、维普数据库2009—2018年期间发表的临床治疗KOA的文献,运用统计、聚类分析等方法,研究骨伤手法治疗KOA的规律。结果:共检索到29篇文献,常用手法的选取率从高到低依次为揉按法、弹拨法、旋转法、屈伸法和揉滚法;常用穴位的选取率从高到低依次为血海、阳陵泉、梁丘、委中、内膝眼;常用解剖部位的选取率从高到低依次为股四头肌、腓肠肌、股二头肌、股内收肌、髌韧带。结论:广东地区中医骨伤手法治疗KOA以局部推拿、整体治疗、缓解粘连为主;穴位选取以局部取穴、补养气血、祛风寒湿邪为主;部位选取以膝周部位、应力集中处为主。

Objective:To analyze and summarize the literatures on Chinese medicine knee osteoarthritis(KOA)in Lingnan area in recent 10 years,represented by Guangdong,and discuss their syndrome and treatment characteristics.Methods:By referring to Chinese medicine textbooks Chinese Medicine Sinew Injury and Chinese Medicine Osteopathy,the literatures on clinical treatment of KOA published by CNKI,Wanfang and VIP databases from 2009 to 2018 were searched,and the rule of the treatment of KOA by Chinese medicine manipulation for orthopedic and traumatic diseases was studied by using statistics and cluster analysis.Results:A total of 29 literatures were retrieved,and the common five kinds of manipulation were kneading and pressing manipulation,flicking and moving manipulation,rotating manipulation,flexing and stretching manipulation as well as kneading and rolling manipulation,in a high-to-low selection rate.The common selected points were xuehai(SP10),yanglingquan(GB34),liangqiu(ST34),weizhong(BL40)and nei xiyan(EX-LE4),in a high-to-low selection rate.The common anatomical sites were quadriceps,gastrocnemius,biceps femoris,adductor femoris and ligament patella,in a high-to-low selection rate.Conclusion:Local Chinese massage,holistic treatment and alleviation of adhesion are the main methods for KOA in Chinese medicine manipulation for orthopedic and traumatic diseases in Guangdong;the points are mainly selected as local points,supplementing and nourishing the qi and blood,and dispelling the wind,cold,dampness and pathogens;the sites are mainly around the knee and the stress concentration area.