骨科疾病中西医协同治疗研究进展

Research Progress on the Integrated Traditional Chinese and Western Medicine Treatment of Orthopedic Diseases

摘要: 骨科疾病作为全球高发慢性病，其防治面临疼痛控制难、功能康复慢、并发症多及长期用药安全性差等挑战。近年来，中西医协同治疗模式在骨科领域展现出独特优势，成为提升临床疗效与患者生活质量的重要路径。本文系统梳理当前骨科中西医协同治疗的研究现状，聚焦中医药参与防治管理的实践路径、中西医病机融通的理论基础、外泌体等新兴技术与中医治法的整合潜力三大核心方向。研究表明，以“内外兼治、情志疏导、膳食调护”为切入点的中医药干预可显著改善骨科患者疼痛(VAS评分降低)、睡眠质量(PSQI评分下降)及并发症发生率(P < 0.05)；中西医协同在重症胰腺炎等跨学科疾病中的成功范式为骨科提供了机制互证与方案迁移的可行性参考；而外泌体所携带的生长因子与中医“活血化瘀”“补益肝肾”治法高度契合，正推动靶向再生治疗的范式革新。当前研究仍受限于高质量RCT证据不足、病机融合深度不够、标准化方案缺失等问题。未来需加强基于真实世界数据的疗效评价体系构建、开展多中心大样本中西医协同诊疗路径验证，并深化“证–病–靶”三维映射下的机制研究，以加速中西医协同治疗从经验走向循证、从个案走向规范。

Abstract: Orthopedic diseases, as highly prevalent chronic conditions worldwide, face multiple challenges in prevention and treatment, including difficulty in pain control, slow functional recovery, frequent complications, and poor long-term medication safety. In recent years, the integrated traditional Chinese and Western medicine treatment model has demonstrated unique advantages in the field of orthopedics and has become an important approach for improving clinical efficacy and patients’ quality of life. This article systematically reviews the current research status of integrated traditional Chinese and Western medicine treatment for orthopedic diseases, focusing on three core directions: practical pathways for the participation of traditional Chinese medicine in prevention and management, the theoretical basis for the integration of pathogenesis in traditional Chinese and Western medicine, and the integrative potential of emerging technologies such as exosomes with traditional Chinese medicine therapeutic methods. Studies have shown that traditional Chinese medicine interventions based on the principles of “treating both internal and external aspects, emotional regulation, and dietary care” can significantly improve pain in orthopedic patients, as reflected by reduced Visual Analog Scale (VAS) scores, improved sleep quality indicated by lower Pittsburgh Sleep Quality Index (PSQI) scores, and decreased complication rates (P < 0.05). Successful collaborative paradigms of traditional Chinese and Western medicine in interdisciplinary diseases such as severe pancreatitis provide orthopedics with feasible references for mutual mechanism validation and therapeutic strategy transfer. Meanwhile, the growth factors carried by exosomes are highly consistent with traditional Chinese medicine approaches such as “promoting blood circulation and removing blood stasis” and “tonifying the liver and kidney,” thereby driving paradigm innovation in targeted regenerative therapy. However, current research remains limited by insufficient high-quality randomized controlled trial evidence, inadequate depth in pathogenesis integration, and the lack of standardized treatment protocols. Future efforts should focus on strengthening efficacy evaluation systems based on real-world data, conducting multicenter large-sample validation of integrated traditional Chinese and Western medicine diagnostic and treatment pathways, and deepening mechanistic studies under the three-dimensional mapping framework of “syndrome-disease-target,” so as to accelerate the transition of integrated traditional Chinese and Western medicine treatment from experience-based practice to evidence-based medicine and from individual cases to standardized practice.