基于亢害承制理论探讨膝骨关节炎的病机及治疗

Based on the Theory of Mutual Restriction and Counteraction to Explore the Pathogenesis and Treatment of Knee Osteoarthritis

摘要: 膝骨关节炎是一种常见的慢性关节疾病，发病机理复杂，西医治疗效果难以满足临床需求。本文运用中医“亢害承制”理论探讨膝骨关节炎的病因病机及治疗思路。“亢害承制”理论强调人体自我平衡、动态稳态的维持与调节。膝骨关节炎的发病与肝肾亏虚的“承制不足”及风寒湿毒等邪气的“亢盛为害”密切相关。肝肾亏虚导致筋骨失养，而邪毒乘虚而入，两者共同导致关节病理变化。在辨证论治中，应从整体出发，在祛除风寒湿毒邪气的同时，注重补益肝肾，调理脾胃，恢复肝、肾、脾对人体的正常调节功能，增强机体的自我修复能力。此外，可根据病情需要，佐以祛风散寒、除湿通络等法，多途径、多环节进行干预调理。通过扶正祛邪、标本兼治，以期恢复机体内环境的动态平衡，最终达到改善关节症状，延缓病程进展的目的。

Abstract: Knee osteoarthritis is a common chronic joint disease with complex pathogenesis, and the effect of western medicine is difficult to meet the clinical needs. In this paper, the theory of “hyperactivity and harmfulness” in traditional Chinese medicine is used to explore the etiology, pathogenesis and treatment of knee osteoarthritis. The theory of “hyperactivity and harmfulness” emphasizes the maintenance and regulation of the body’s self-balance and dynamic homeostasis. The onset of knee osteoarthritis is closely related to the “insufficient control” of liver and kidney deficiency and the “hyperactivity” of wind, cold, dampness and toxin. Liver and kidney deficiency leads to the loss of muscles and bones, and the evil toxin takes advantage of the deficiency, which together leads to the pathological changes of the joint. In the treatment of syndrome differentiation, we should start from the whole, while eliminating the wind, cold, dampness and toxin, pay attention to tonifying the liver and kidney, regulating the spleen and stomach, recovering the normal regulation function of the liver, kidney and spleen to the human body, and enhancing the self-repair ability of the body. In addition, according to the needs of the disease, we can use the methods of dispelling wind and cold, removing dampness and dredging collaterals to intervene and regulate in multiple ways and links. By strengthening the body resistance and eliminating evil, treating both the symptoms and the root cause, in order to restore the dynamic balance of the internal environment of the body, and finally achieve the purpose of improving joint symptoms and delaying the progress of the disease.