楊生民主任醫(yī)師治療膝骨性關節(jié)病學術思想及臨床經驗研究
發(fā)布時間：2019-03-01 08:59
【摘要】：楊生民老師是洛陽正骨醫(yī)院主任醫(yī)師,全國名老中醫(yī),第五批全國名老中醫(yī)藥專家學術繼承指導老師,從事臨床工作30余年,治學嚴謹、醫(yī)德高尚。楊老師對中醫(yī)經典著作和歷代名家學術思想頗有研究,在結合傳統(tǒng)中醫(yī)骨傷基礎理論的基礎上,注重中醫(yī)現(xiàn)代化研究,臨床經驗豐富,勤求古訓,博采眾長,在總結前人經驗的基礎上,結合自身的臨床經驗,形成了系統(tǒng)的學術思想和臨證思路。楊生民老師認為膝關節(jié)骨性關節(jié)病病因病機為本虛標實,肝腎虧虛為本,痰凝血瘀,脈絡瘀阻為標。根據上述病機,楊老師認為,膝關節(jié)骨性關節(jié)病的治則應以補益肝腎,化痰祛瘀,通經活絡為大法。同時提倡內治與外治相結合,中西醫(yī)結合,以內治為主,兼用外治。外治法,包括手法治療,中藥熏洗治療,中藥塌漬治療,灸法,小針刀治療,膏藥外敷,中藥外用方法是以活血通絡,化瘀止痛的中藥,通過皮膚吸收直達病所,起效快,無毒副作用,患者依從性好,有利于疾病痊愈。楊老師臨癥重視把辨證論治、辨病論治與對癥治療相結合,在疾病不同階段采取不同方法,急則治其標,緩則治其本,對于早期疼痛劇烈患者應取手法治療,小針刀治療,對病久關節(jié)軟骨退變嚴重及關節(jié)間隙嚴重狹窄患者行關節(jié)置換手術�！拔床∠确�,既病防變”一直是中醫(yī)學臨床的重要指導思想。關于膝骨性關節(jié)病的預防,主要針對可能導致本病發(fā)生的的機制,阻斷疾病發(fā)生發(fā)展的過程,才能預防疾病發(fā)生。本病的主要病因包括感受外感風寒濕邪、肝腎不足、氣滯血瘀、脈絡瘀阻,從而導致疾病發(fā)生發(fā)展。所以補肝腎,益氣血在預防和治療本病中具有重要作用。為了全面系統(tǒng)學習及傳承楊老師的臨床經驗和學術思想,本文采用了臨床研究與回顧性文獻研究相結合的方法,從膝關節(jié)骨性關節(jié)病的發(fā)病病因病機,診斷方法、治療原則,以及疾病預防方面進行整理總結。結合三年跟師學習知識,應用于臨床,制定治療方案,觀察治療效果,證實內治和外治相結合,中西醫(yī)相結合治療膝關節(jié)骨性關節(jié)病療效更好,更科學。
[Abstract]:Teacher Yang Shengmin is the chief physician in Luoyang Orthopaedic Hospital, a well-known senior Chinese medicine practitioner throughout the country, and the fifth group of senior Chinese medicine experts in the country. He has been engaged in clinical work for more than 30 years, and is rigorous in his studies and noble in medical ethics. On the basis of combining the basic theory of traditional Chinese medicine bone injury, teacher Yang pays attention to the study of modernization of traditional Chinese medicine, has rich clinical experience, diligently pursues ancient training, and draws lessons from all kinds of people. On the basis of summarizing the predecessors' experience and combining their own clinical experience, the systematic academic thought and clinical thinking have been formed. Teacher Yang Shengmin thought that the pathogeny and pathogenesis of knee osteoarthropathy were deficiency-based, deficiency of liver and kidney, phlegm-blood stasis and choroidal stasis. According to the above-mentioned pathogenesis, Yang believes that the treatment of knee osteoarthropathy should be based on nourishing the liver and kidney, removing phlegm and removing blood stasis, and activating meridians and activating collaterals. At the same time, promote the combination of internal and external treatment, the combination of traditional Chinese and western medicine, mainly internal treatment, both external treatment. External treatment, including manipulation treatment, traditional Chinese medicine fumigation and washing treatment, traditional Chinese medicine collapse treatment, moxibustion method, small needle knife treatment, plaster external application, the external use of traditional Chinese medicine is to Huoxue Tongluo, removing blood stasis and pain relief of the traditional Chinese medicine, through the skin absorption directly to the disease, effective quickly. Non-toxic side effects, patient compliance is good, conducive to the recovery of the disease. Teacher Yang attaches great importance to the treatment of syndrome differentiation, differentiation of diseases and symptomatic treatment. In different stages of the disease, different methods are adopted to treat the symptoms as soon as possible and slowly, and the patients with severe pain in the early stage should be treated by manipulation and small needle knife. The patients with severe degeneration of articular cartilage and severe stenosis of joint space were treated with arthroplasty. It has always been an important guiding ideology of TCM clinical practice that "prevent disease first, prevent disease and change". The prevention of knee osteoarthropathy is mainly aimed at the mechanism that may lead to the occurrence of the disease, blocking the process of the occurrence and development of the disease, so as to prevent the occurrence of the disease. The main causes of the disease include feeling external wind, cold and dampness, deficiency of liver and kidney, stagnation of qi and blood stasis, obstruction of vein, thus leading to the occurrence and development of the disease. Therefore, tonifying the liver and kidney, nourishing qi and blood play an important role in the prevention and treatment of this disease. In order to comprehensively and systematically study and inherit teacher Yang's clinical experience and academic ideas, this paper adopts the method of combining clinical research and retrospective literature study, from the etiology, pathogenesis, diagnosis, treatment principle of knee joint bony arthropathy. And the disease prevention aspect carries on the sorting summary. Combined with the knowledge of the teacher for three years, it is better and more scientific to apply it to the clinic, to formulate the treatment plan, to observe the therapeutic effect, to confirm the combination of internal treatment and external treatment, and to combine the traditional Chinese medicine and western medicine in the treatment of knee joint bony joint disease.
【學位授予單位】：河南中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R249;R274.9
本文編號：2432278
[Abstract]:Teacher Yang Shengmin is the chief physician in Luoyang Orthopaedic Hospital, a well-known senior Chinese medicine practitioner throughout the country, and the fifth group of senior Chinese medicine experts in the country. He has been engaged in clinical work for more than 30 years, and is rigorous in his studies and noble in medical ethics. On the basis of combining the basic theory of traditional Chinese medicine bone injury, teacher Yang pays attention to the study of modernization of traditional Chinese medicine, has rich clinical experience, diligently pursues ancient training, and draws lessons from all kinds of people. On the basis of summarizing the predecessors' experience and combining their own clinical experience, the systematic academic thought and clinical thinking have been formed. Teacher Yang Shengmin thought that the pathogeny and pathogenesis of knee osteoarthropathy were deficiency-based, deficiency of liver and kidney, phlegm-blood stasis and choroidal stasis. According to the above-mentioned pathogenesis, Yang believes that the treatment of knee osteoarthropathy should be based on nourishing the liver and kidney, removing phlegm and removing blood stasis, and activating meridians and activating collaterals. At the same time, promote the combination of internal and external treatment, the combination of traditional Chinese and western medicine, mainly internal treatment, both external treatment. External treatment, including manipulation treatment, traditional Chinese medicine fumigation and washing treatment, traditional Chinese medicine collapse treatment, moxibustion method, small needle knife treatment, plaster external application, the external use of traditional Chinese medicine is to Huoxue Tongluo, removing blood stasis and pain relief of the traditional Chinese medicine, through the skin absorption directly to the disease, effective quickly. Non-toxic side effects, patient compliance is good, conducive to the recovery of the disease. Teacher Yang attaches great importance to the treatment of syndrome differentiation, differentiation of diseases and symptomatic treatment. In different stages of the disease, different methods are adopted to treat the symptoms as soon as possible and slowly, and the patients with severe pain in the early stage should be treated by manipulation and small needle knife. The patients with severe degeneration of articular cartilage and severe stenosis of joint space were treated with arthroplasty. It has always been an important guiding ideology of TCM clinical practice that "prevent disease first, prevent disease and change". The prevention of knee osteoarthropathy is mainly aimed at the mechanism that may lead to the occurrence of the disease, blocking the process of the occurrence and development of the disease, so as to prevent the occurrence of the disease. The main causes of the disease include feeling external wind, cold and dampness, deficiency of liver and kidney, stagnation of qi and blood stasis, obstruction of vein, thus leading to the occurrence and development of the disease. Therefore, tonifying the liver and kidney, nourishing qi and blood play an important role in the prevention and treatment of this disease. In order to comprehensively and systematically study and inherit teacher Yang's clinical experience and academic ideas, this paper adopts the method of combining clinical research and retrospective literature study, from the etiology, pathogenesis, diagnosis, treatment principle of knee joint bony arthropathy. And the disease prevention aspect carries on the sorting summary. Combined with the knowledge of the teacher for three years, it is better and more scientific to apply it to the clinic, to formulate the treatment plan, to observe the therapeutic effect, to confirm the combination of internal treatment and external treatment, and to combine the traditional Chinese medicine and western medicine in the treatment of knee joint bony joint disease.
【學位授予單位】：河南中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R249;R274.9
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