楊生民主任醫(yī)師治療膝骨性關(guān)節(jié)病學(xué)術(shù)思想及臨床經(jīng)驗(yàn)研究
發(fā)布時(shí)間：2019-03-01 08:59
【摘要】：楊生民老師是洛陽(yáng)正骨醫(yī)院主任醫(yī)師,全國(guó)名老中醫(yī),第五批全國(guó)名老中醫(yī)藥專家學(xué)術(shù)繼承指導(dǎo)老師,從事臨床工作30余年,治學(xué)嚴(yán)謹(jǐn)、醫(yī)德高尚。楊老師對(duì)中醫(yī)經(jīng)典著作和歷代名家學(xué)術(shù)思想頗有研究,在結(jié)合傳統(tǒng)中醫(yī)骨傷基礎(chǔ)理論的基礎(chǔ)上,注重中醫(yī)現(xiàn)代化研究,臨床經(jīng)驗(yàn)豐富,勤求古訓(xùn),博采眾長(zhǎng),在總結(jié)前人經(jīng)驗(yàn)的基礎(chǔ)上,結(jié)合自身的臨床經(jīng)驗(yàn),形成了系統(tǒng)的學(xué)術(shù)思想和臨證思路。楊生民老師認(rèn)為膝關(guān)節(jié)骨性關(guān)節(jié)病病因病機(jī)為本虛標(biāo)實(shí),肝腎虧虛為本,痰凝血瘀,脈絡(luò)瘀阻為標(biāo)。根據(jù)上述病機(jī),楊老師認(rèn)為,膝關(guān)節(jié)骨性關(guān)節(jié)病的治則應(yīng)以補(bǔ)益肝腎,化痰祛瘀,通經(jīng)活絡(luò)為大法。同時(shí)提倡內(nèi)治與外治相結(jié)合,中西醫(yī)結(jié)合,以內(nèi)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(luò),化瘀止痛的中藥,通過(guò)皮膚吸收直達(dá)病所,起效快,無(wú)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(duì)癥治療相結(jié)合,在疾病不同階段采取不同方法,急則治其標(biāo),緩則治其本,對(duì)于早期疼痛劇烈患者應(yīng)取手法治療,小針刀治療,對(duì)病久關(guān)節(jié)軟骨退變嚴(yán)重及關(guān)節(jié)間隙嚴(yán)重狹窄患者行關(guān)節(jié)置換手術(shù)�！拔床∠确�,既病防變”一直是中醫(yī)學(xué)臨床的重要指導(dǎo)思想。關(guān)于膝骨性關(guān)節(jié)病的預(yù)防,主要針對(duì)可能導(dǎo)致本病發(fā)生的的機(jī)制,阻斷疾病發(fā)生發(fā)展的過(guò)程,才能預(yù)防疾病發(fā)生。本病的主要病因包括感受外感風(fēng)寒濕邪、肝腎不足、氣滯血瘀、脈絡(luò)瘀阻,從而導(dǎo)致疾病發(fā)生發(fā)展。所以補(bǔ)肝腎,益氣血在預(yù)防和治療本病中具有重要作用。為了全面系統(tǒng)學(xué)習(xí)及傳承楊老師的臨床經(jīng)驗(yàn)和學(xué)術(shù)思想,本文采用了臨床研究與回顧性文獻(xiàn)研究相結(jié)合的方法,從膝關(guān)節(jié)骨性關(guān)節(jié)病的發(fā)病病因病機(jī),診斷方法、治療原則,以及疾病預(yù)防方面進(jìn)行整理總結(jié)。結(jié)合三年跟師學(xué)習(xí)知識(shí),應(yīng)用于臨床,制定治療方案,觀察治療效果,證實(shí)內(nèi)治和外治相結(jié)合,中西醫(yī)相結(jié)合治療膝關(guān)節(jié)骨性關(guān)節(jié)病療效更好,更科學(xué)。
[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(xué)位授予單位】：河南中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R249;R274.9
本文編號(hào)：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(xué)位授予單位】：河南中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R249;R274.9
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