膝骨关节炎(膝痹)中西医结合临床实践指南

Clinical practice guidelines for knee osteoarthritis in integrated traditional chinese and western medicine

膝骨关节炎(knee osteoarthritis,KOA)是当前常见的慢病之一,严重影响患者的身心健康和生存质量。中西医结合在KOA全病程管理中优势确切,基于循证医学制定的KOA中西医临床实践指南具有重要的意义,有助于规范中西医临床诊疗技术,取得更好的疗效。本指南按照临床实践指南的规范编写,从范围、术语和定义、流行病学特点、诊断、治疗、疗效评价等方面对KOA的中西医诊疗流程进行了规范。在中医辨病和辨证方面,本指南强调了地域特色对KOA发生、发展及中医证型分布的影响。在治疗方面,强调了运动训练在KOA全病程管理中的重要作用,并对运动训练的方式、方法、动作细节、强度及疗程等做出了有关推荐;同时亦强调了中医特色技术如针灸、小针刀、穴位注射等在本病非手术治疗中的应用。本指南具有较好的临床适用性、安全性及有效性。

Knee osteoarthritis(KOA)is one of the most commonfrequent chronic diseases today,and it has a significant impact on a patient’s physical,mental,and social well-being. Treatment combining Traditional Chinese Medication(TCM)and western medicine has undeniably proven to be beneficial in the overall management of KOA. The KOA instruction in TCM and western medicine clinical practice is extremely important,as it was written on the basis of Evidence-based Medicine. It aids in the standardization and improvement of diagnostic and treatment practices in both Chinese and Western medicine. The instruction was created in accordance with the clinical practice guideline’s standards.It excludes standards such as range,words,definitions,epidemic characteristics,diagnosis,treatment,effect evaluation,and other components of the KOA diagnostic and treatment process in TCM and western medicine.The instruction was created in accordance with the clinical practice guideline’s standards. It excludes standards such as range,words,definitions,epidemic characteristics,diagnosis,treatment,effect evaluation,and other components of the KOA diagnostic and treatment process in TCM and western medicine.In terms of disease differentiation and syndrome differentiation of TCM,this instruction highlights the influence of territorial characteristic on KOA occurrence,development,and distribution of different syndrome types in TCM.With regards to the aspect of treatment,the instruction highlights the exercise and training’s importance on the whole KOA treatment management. More than that,the instruction provides recommendation on the exercise/training way,method,movement detail,intensity and treatment course. Besides,some techniques applied in non-operative KOA treatment are underscored in this instruction,such as acupuncture,small needle-knife,acupoint injection,and so on. This training adapts well to clinical practice and is both safe and effective.