基于“筋伤、节错、骨病”辨证探讨膝骨关节炎的治疗策略

Treatment strategy of knee osteoarthritis based on the ‘tendon injury,joints dislocation and bone disease’ theory

膝骨关节炎作为一种常见的慢性筋骨病,传统伤科辨证在临床诊疗过程中缺乏精准性和针对性。林定坤教授在中医筋骨失衡的理念基础上,结合现代解剖知识,将膝关节结构概括为“筋、节、骨”。临床上,先区分疼痛的部位,定病位在“筋”、在“节”、在“骨”;再结合按诊、症状、体征等信息,定病性,判断是“筋伤”“节错”还是“骨病”,形成筋伤疗筋,节错调节,骨病治骨,或筋、节、骨同治的膝骨关节炎治疗策略。新的膝骨关节炎筋骨辨证体系能更精准指导临床诊疗工作,从而提高临床疗效。

As a common chronic bone and muscle disease, knee osteoarthritis lacks precision and pertinence in the clinical diagnosis and treatment of traditional traumatology syndrome differentiation. Professor LIN Ding-kun summarized the structure of knee joint as ‘tendons, joints and bones’ on the basis of the concept of imbalance between bones and muscles in traditional Chinese medicine and modern anatomical knowledge. Clinically, we should first distinguish the location of pain, and determine the location of the disease in tendons, joints and bones. Combined with the information of diagnosis, symptoms, signs,etc., determine the nature of the disease and judge whether it is ‘tendon injury’, ‘joint dislocation’ or ‘bone disease’, and form a treatment strategy of knee osteoarthritis by treating tendon injury, adjusting joint error, treating bone disease or treating tendon,joint and bone together. The new bone and muscle syndrome differentiation system of knee osteoarthritis can guide clinical diagnosis and treatment more accurately, thus improving clinical curative effect.