从“筋骨、痹痿、虚实、动静、刚柔”谈膝骨关节炎康复

Rehabilitation of Knee Osteoarthritis with Conception of"Muscles and Bones,Arthralgia and Flaccidity,Asthenia and Sthenia,Dynamic and Static,Hardness and Softness"

膝骨关节炎(KOA)功能障碍具有"筋骨同病、痹痿并见、虚实错杂、动静失衡、刚柔失常"等特点。在该病的早、中、晚三期,相关功能障碍在"筋骨、痹痿、虚实、动静、刚柔"的具体表现又各有所侧重,故KOA的中医康复治疗应分期辨证实施。本研究从"筋骨同调、痹痿并重、虚实兼顾、动静结合、刚柔相济"5个方面分别阐释KOA功能障碍的中医康复原则与思路:"筋骨同调"是针对KOA所致功能障碍的基本病机特征,从病位出发,采用相应的康复治法以达到强筋壮骨的目的;"痹痿并重、虚实兼顾"是针对KOA功能障碍的基本表现特点,从病性出发,采用相应的康复治法以达到除痹起痿、调理虚实的目的;"动静结合"是针对导致KOA病情反复及加重的重要因素,从病因出发,采用相应的康复治法以达到动静相宜的目的;"刚柔相济"是针对KOA功能障碍刚柔异常的特征,从病状和病因出发,采用相应的康复治法以达到刚柔并济的目的。本研究旨在进一步完善KOA的中医康复治疗理论,为其临床康复提供参考。

The dysfunction of knee osteoarthritis(KOA)is characterized with"comorbidity of tendons with bones,coexistence of arthralgia and flaccidity,mixture of asthenia with sthenia,imbalance between dynamic and static statuses,and disorder between hardness and softness".In the early,middle and late stages of the disease,the related functional disorders have their own emphasis on the specific manifestations of"muscles and bones,arthralgia and flaccidity,asthenia and sthenia,dynamic and static,hardness and softness",so the traditional Chinese medicine(TCM)rehabilitation treatment of KOA should also be applied according to syndrome differentiation by stages.This article explains the principles and ideas of TCM rehabilitation for KOA dysfunction from five aspects:"the coordination of muscles and bones,equal emphasis on arthralgia and flaccidity,consideration of both asthenia and sthenia,combination of dynamic and static,and combination of hardness and softness".The coordination of muscles and bones refers to the basic pathogenesis characteristics of dysfunction caused by KOA,starting from the disease position,and adopting corresponding rehabilitation treatments to achieve the purpose of strengthening the muscles and bones.Equal emphasis on arthralgia and flaccidity,consideration of both asthenia and sthenia are aimed at the the basic performance characteristics of KOA dysfunction,starting from the the nature of the disease and adopting the corresponding rehabilitation therapy to achieve the purpose of eliminating arthralgia and flaccidity,regulating asthenia and sthenia.Combination of dynamic and static aims at the important factors that cause the repeated and aggravated condition of KOA,starting from the cause of the disease and adopting the corresponding rehabilitation therapy to achieve the purpose of balancing dynamic and static.Combination of hardness and softness aims at the important characteristics of KOA dysfunction,starting from the condition and cause of the disease,adopting the corresponding rehabilitation therapy to achieve the purpose of strengthening the bones and muscles.The analysis aims to further improve the theory of TCM rehabilitation of KOA and provide certain references for its clinical rehabilitation.