| 引用本文: |
徐瑞洋, 周敏, 陆燕.从“水火既济，气血运和”理论探讨膝骨关节炎的中医辨治思路[J].湖南中医药大学学报,2026,46(3):589-594[点击复制] |
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| 从“水火既济，气血运和”理论探讨膝骨关节炎的中医辨治思路 |
| 徐瑞洋,周敏,陆燕 |
| (南京中医药大学附属医院, 江苏 南京 210029;南京中医药大学第二附属医院, 江苏 南京 210017) |
| 摘要: |
| 膝骨关节炎（KOA）是一种以关节软骨退变和骨质增生为主要特征的慢性退行性疾病，属于中医学“骨痹”“膝痹”范畴。中医学认为，KOA病机本质为本虚标实，心肾失调、阴阳失衡为发病之枢，气血失和、经络痹阻为本病之标象。本文基于“水火既济，气血运和”理论，结合中医经典治疗痹证的经验，提出以“调心肾济水火、和气血通经络”为总原则，构建扶正固本与祛邪通络相结合的KOA治疗方案。其中，以调心肾、济水火为核心方向，以健脾养肝生气血、祛风除湿通经络为协同路径。附验案一则加以阐明，以期为KOA的治疗提供新思路。 |
| 关键词: 膝骨关节炎 骨痹 水火既济 心肾相交 气血运和 |
| DOI：10.3969/j.issn.1674-070X.2026.03.021 |
| 投稿时间：2025-10-23 |
| 基金项目:江苏省卫生健康委员会中医药科技发展专项课题（2020ZX09）；江苏省教育厅研究生实践创新计划项目（SJCX24-0989）；江苏省中医院科主任学术提升专项课题（Y2022ZR01）。 |
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| Exploration of TCM pattern identification and treatment strategies for knee osteoarthritis based on the theory of "coordination between the heart and the kidney with harmonized qi and blood circulation" |
| XU Ruiyang, ZHOU Min, LU Yan |
| (Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210029, China;Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210017, China) |
| Abstract: |
| Knee osteoarthritis (KOA) is a chronic degenerative disease characterized primarily by articular cartilage degeneration and osteophyte formation, categorized in TCM as "bone impediment" and "knee impediment". According to TCM theory, the pathogenesis of KOA is essentially a pattern of root deficiency with manifestation excess. Disharmony between the heart and kidney and imbalance of yin and yang serve as the pivotal factors in its onset, while disharmony between qi and blood and obstruction of meridians present as the clinical manifestations. Based on the theory of "coordination between the heart and the kidney with harmonized qi and blood circulation" and classical TCM experience in treating impediment patterns, this paper proposes the general principle of "regulating the heart and kidney to coordinate the water and fire, and harmonizing qi and blood to unblock the meridians," constructing a treatment strategy for KOA that combines reinforcement of the healthy qi to strengthen the body with elimination of pathogenic factors to unblock the meridians. The core focus is on regulating the heart and kidney to coordinate the water and fire, with synergistic pathways including strengthening the spleen and nourishing the liver to generate qi and blood, as well as eliminating wind and removing dampness to unblock the meridians. A verified medical record is presented to illustrate this approach, aiming to provide new perspectives for KOA treatment. |
| Key words: knee osteoarthritis bone impediment coordination between water and fire harmony between the heart and the kidney harmonized qi and blood circulation |
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