早期骨性关节炎的临床诊断与治疗

中西结合治疗早期骨性关节炎

文海全医师

【中文摘要】随着社会人口年龄老化，早期骨性关节炎发病率逐年上升的趋势，迫切需要为本病提供理想的治疗方法，认清本病的病因及发病机制是有效治疗的基础，特别对预防本病的发生可以进行预测和指导，做到“未病先防，既病早治”。中医认为本病属本虚标实，主要从肝肾亏虚、脾虚痰湿、气血瘀滞及风寒湿痹等方面辨证论治，应用针灸推拿，中药内服外用等多种方法，整体与局部并治，在预防和早、中期治疗上具有明显优势，但远期效果不理想，仍有复发可能。现代医学则通过分析理化特性的改变，依据关节病变程度不同给予不同的治疗，病变早期以药物治疗为主，晚期则通过手术来改善生活质量，但手术也只能作为一种补救措施，也不可能真正替代复杂的人体关节结构。因此，结合中西医两方面的优势，探索本病的中西病因病理，针对性地制定出一套系统化、规范化、合理化的治疗方案，应该是目前乃至以后的一个研究与努力的方向。【关键词】骨性关节炎、早期骨性关节炎、诊断、治疗

Clinical Diagnosis and Treatment of Initial Stage Osteoarthritis 【Abstract】There has been an increase in the diagnosis of initial stage osteoarthritis as the society faces an aging population. Thus, it is important to grasp the basic knowledge of the disease by understanding the causes, signs and symptoms, and its mechanisms so as to pro vide the ideal treatment. As the saying goes, “Prevention is better than cure”, it is crucial to know the appropriate preventive measures to help us curb the ailment early. Osteoarthritis has been a common degenerative disease. Traditional Chinese Medicine claims the cause of this disease as deficiency in origin and/or excess in superficiality. Symptoms of the disease may include deficiency of the liver and kidney, phlegm “dampness” due to hypofunction of the spleen, stagnation of qi and blood, arthralgia due to wind-cold-dampness. Treatment of osteoarthritis can be varied as Acupuncture, tuina, oral and topical medications are commonly employed to treat this disease. A combination of localized and holistic treatments is helpful in the initial and intermediate stages of treatment and prevention. However, due to the complicated nature of osteoarthritis, long-term treatments may not be helpful and one is likely to face a relapse. With the changes made in the thesis of modern medical-science technology, the treatments for osteoarthritis are customized due to the different progress of individual disease status. In the initial stages, it is recommended that patients undergo pharmacological therapy and if the condition reaches the later stages, patients may need to go through an operation. However, surgery only help to enhance the patient’s quality of life but it cannot replace the complicated human structures entirely, in this case the joints. Thus, it is important to gather the essential knowledge and strengths of both traditional and western medicine to help us come out with the best treatment for osteoarthritis. With that, the current as well as the future goals would be to establish a unique system for standardizing and formularizing the treatment process.

【Key words】osteoarthritis、Initial stage osteoarthritis/pre-osteoarthritis、diagnosis、treatment

前言

随着社会人口年龄老化，早期骨性关节炎发病率逐年上升的趋势，迫切需要为本病提供理想的治疗方法，认清本病的病因及发病机制是有效治疗的基础，特别对预防本病的发生可以进行预