基于“络病理论”探讨膝骨关节炎的病因机制

Etiology and Pathogenesis of KOA Based on ’Collateral Disease Theory’

膝骨关节炎(KOA)是多种原因引起的退行性、不可逆转的骨关节疾病,是中老年人的常见病、多发病,严重影响中老年患者的身心健康与生活质量,加重社会的医疗负担。该病的发病机制十分复杂,尚不完全清楚,具有难治性等特点。近年来,在中医基础理论的指导下,中医药在慢性复杂性疾病中被广泛应用,尤其在治疗膝骨关节炎中已突显巨大优势。众多医家认为“肝肾亏虚、痰瘀伏络”是膝骨关节炎病机演变的关键环节,本文结合中医学“络病理论”,探讨膝骨关节炎的病因机制,发现二者在病因病机和临床症状方面均具有紧密相关性,进一步说明络脉“瘀”与KOA微循环障碍本质上的一致性,并通过活血通络法疏通微循环淤滞,从而缓解关节软骨退变并修复损伤。

Knee osteoarthritis(KOA)is a degenerative and irreversible bone and joint disease caused by many reasons.It is a common and frequently occurring disease of the middle-aged and elderly,which seriously affects the physical and mental health and life quality of the middle-aged and elderly patients and aggravates the medical burden of the society.The pathogenesis of the disease is very complex and unclear,and the disease has refractory characteristics.In recent years,under its basic theory guidance,TCM has been widely applied in chronic complex diseases,especially shows significant advantage in the treatment of KOA.Many doctors believe that’deficiency of Liver and Kidney,phlegm and blood stasis lurking collaterals’ is the key link in the pathogenesis evolution of KOA.Combined with the ’collateral disease theory’of TCM,this study discussed the etiology and pathogenesis of KOA,and found that there was a close association between them in terms of etiology and pathogenesis and clinical symptoms,it further proved that’stasis’ is consistent with microcirculatory disturbance,which could be improved by activating blood circulation and dredging collaterals to alleviate the degeneration and injury recovery of articular cartilage.