基于玄府理论探析风药在膝骨关节炎中的运用

Exploration on the application of wind medicine in treating knee osteoarthritis based on the Xuanfu theory

膝骨关节炎是临床骨科十分常见的退行性骨关节疾病,它的主要特征是关节软骨进行性退化和缺失,伴有整个关节的结构和功能变化,包括滑膜、半月板、关节周围韧带和软骨下骨。临床以缓慢进展的关节疼痛、肿胀、关节僵硬或畸形为主要表现,严重威胁中老年人群的健康,归属于中医学“膝痹”的范畴。玄府作为迄今中医学有关人体结构层次中最细微的结构单位,由细小孙络进一步分化而来,是机体“精神、荣卫、血气、津液出入流行”的道路门户,分布广泛。玄府理论强调“贵开忌阖、以通为顺”。玄府郁闭、开阖失司,气血津液升降出入障碍,不通则痛,是膝痹发生、发展的基本病机。风药味薄气轻,药性轻灵,升浮发散,得风气之先,畅达机体上下内外,走而不守,既可开发肌表之玄府,又可打通人体脏腑组织的玄府,是临床使用频率最高、疗效最佳的一类开通玄府的药物。风药具有“升、散、透、窜、通、燥、动”等特性,在开通玄府中发挥着重要作用。文章以探析玄府理论、膝骨关节炎以及风药特性之间的相关性为出发点,从行气开玄、活血开玄、燥湿开玄、补虚通玄等角度阐述风药在膝骨关节炎治疗中的作用机制,以期丰富膝骨关节炎中医药治疗的理论体系,为中医药防治膝骨关节炎提供新思路。

Knee osteoarthritis is a very common degenerative osteoarticular disease in clinical orthopedics,and its main feature is progressive degeneration and loss of articular cartilage,accompanied by structural and functional changes of the entire joint,including changes in synovium,meniscus,periarticular ligaments and subchondral bone.Clinically,slow-progressing joint pain,swelling,joint stiffness or deformity are the main manifestations,which seriously threaten the health of middle-aged and elderly people.It belongs to the category of knee paralysis in TCM.As the most subtle structural unit in the structural level of the human body in TCM,Xuanfu( 玄 府) is further differentiated from the minute collateral,and is the road gateway of the body's spirit,Rongwei( 荣卫),blood and liquid widely distributed.Xuanfu theory emphasizes fluenting and smoothly.Disorder of Xuanfu is the basic cause of the occurrence and development of knee paralysis.The wind medicine is thin and light,the medicinal properties are light and spiritual,can not only develop the Xuanfu of the muscle surface,but also open up the Xuanfu of the human internal organs,is a class of drugs with the highest frequency of clinical use and the best curative effect in opening Xuanfu.Wind medicine has the characteristics of rising,dispersing,penetrating,channeling,opening,dryness,and movement,and plays an important role in opening Xuanfu.This paper takes the analysis of the correlation between the Xuanfu theory,knee osteoarthritis and the characteristics of wind medicine as the starting point,and expounds the mechanism of wind medicine in the treatment of knee osteoarthritis,in order to enrich the theoretical system of TCM treatment of knee osteoarthritis,and provide new ideas for the prevention and treatment of knee osteoarthritis with TCM medicine.