膝骨性关节炎早、中期的中医辨证论治研究

Study on Syndrome Differentiation and Treatment for Knee Osteoarthritis at Early and Middle Stages

从病因病机、辨证论治2方面入手探讨早、中期膝骨性关节炎(KOA)的中医辨证论治特色,指出风寒湿邪外袭以及跌倒损伤是KOA发病的外在因素,肝肾亏虚是内在因素;KOA早、中期的治疗可分为内治法、外治法、内外兼治法(中医综合疗法),外治法又分膏药贴敷法、中药热熨法、小针刀、针灸、中药离子导入法等,均取得了较好疗效,但今后应着重机理方面的研究,同时应进行大样本、多中心、随机、多盲试验,提供可信度更高的证据,制定出更加合理有效的KOA早、中期中医诊疗标准,以提高疗效。

The unique features of syndrome differentiation and treatment for KOA at early and middle stages were explored from the causes,the pathogenesis,syndrome differentiation and treatment,it was pointed out that external attack of wind,cold and dampness,falling and injury were the external factors of KOA attacking,deficiency of liver and kidney was internal factor;therapy for KOA at early and middle stages could be divided into internal therapy,external therapy,internal and external method(TCM comprehensive therapy),external therapy contained plaster application,hot ironing of TCM,needle knife,acupuncture,herbal iontophoresis and others,and it has obtained better clinical effects,while in the future the study on the mechanism should be stressed,simultaneously,large-sample,muliti-center,randomized and multi blind trials could be started to provide the evidence with high confidence level,to establish more rational and effective diagnostic and therapeutic criteria of TCM for KOA at early and moderate state,in order to raise clinical effects.