曹东波中医内外合治肩周炎思路探析

An analysis of CAO Dongbo’s Approach to Treating Frozen Shoulder using both Internal and External Traditional Chinese Medicine

曹东波教授针对肩周炎的临床诊疗模式为通过四诊及必要时借助影像学检查尽可能明确诊断,初步排除心脑血管等急危重症疾病与肩关节周围相关的危重疾病;同时以“坚持整体观与局部辨证相结合”为诊断思路,以“从寒治痛与身痛治肝,内外合治”为治疗思想。尤其中医外治法运用历史悠久疗效确切安全性高,所以曹东波教授强调对肩周炎进行局部辨证,结合五体理论来辨证肩周炎所处的病变层次,注重体表可触及的筋、脉、肉、皮、骨等形体结构,准确定位病变层次,又要注重不同的层次之间互相影响从而共同发病的关系,同时将不同的中医外治法进行有机组合以更好提高临床疗效。学习总结经验,有助于充分发挥汤剂特色和中医外治法特色来指导中医筋伤病临床实践。

Professor CAO Dongbo’s clinical diagnosis and treatment model for frozen shoulder is to make the di-agnosis as clear as possible through four diagnostics and,if necessary,imaging examinations,and to initially rule out acute and critical diseases such as cardiovascular and cerebrovascular diseases and critical diseases related to the shoulder joint;at the same time,he adopts the principle of“persistence”“Combining the overall view with local syn-drome differentiation”is the diagnostic idea,and the treatment idea is“treating cold pain and body pain,treating the liver,and combining internal and external treatment”.In particular,the external treatment method of traditional Chi-nese medicine has a long history of accurate efficacy and high safety.Therefore,Professor CAO Dongbo emphasizes local dialectics of frozen shoulder,combining the five-body theory to diagnose the level of lesions of frozen shoulder,paying attention to the tendons,pulses,and veins that can be touched on the body surface.Physical structures such as flesh,skin,and bones must be used to accurately locate the disease levels.At the same time,attention must be paid to the mutual influence between different levels and the co-occurrence of diseases.At the same time,different external treatments of traditional Chinese medicine can be organically combined to better improve clinical efficacy.Learning and summarizing experience will help to give full play to the characteristics of decoction and external treatment meth-ods of traditional Chinese medicine to guide the clinical practice of traditional Chinese medicine for tendon injuries.