基于“筋骨并调”与“远程取穴”理论的谢氏正骨疗法治疗颞下颌关节紊乱病临证经验及康复指导

Xie’s Orthopedic Therapy Based on the Theories of “Coordinating Muscles and Bones” and “Remote Acupoint Selection” for Treating Temporomandibular Disorders: Clinical Experience and Rehabilitation Guidance

摘要: 颞下颌关节紊乱病(TMD)是口腔颌面及骨伤科的常见病、多发病，具有病程长、易复发的特点。四川省非物质文化遗产“谢氏正骨疗法”在骨伤科疾病诊疗中形成了独特的“以筋带骨、以气运血”学术思想。文章总结了谢氏正骨流派对TMD的病因病机认识，系统阐述了包括谢氏定点旋转复位、颞颌关节松动术及针灸在内的特色中医疗法，并创新性地引入现代康复筋膜链理论，提出“下肢驱动–核心稳定–颅颌联动”的康复锻炼体系。通过局部与远端相结合的功能锻炼指导，旨在重建咬合生物力学平衡，提高临床疗效，降低复发率。

Abstract: Temporomandibular disorders (TMD) are common and frequently occurring diseases in oral and maxillofacial surgery and orthopedic trauma, characterized by a long course and easy recurrence. The Sichuan intangible cultural heritage “Xie Orthopedic Therapy” has formed a unique academic concept of “guiding bone with tendons, promoting blood circulation with qi” in the diagnosis and treatment of orthopedic diseases. This article summarizes the Xie Orthopedic School’s understanding of the etiology and pathogenesis of TMD, systematically elaborates on characteristic traditional Chinese medical treatments, including Xie’s fixed-point rotational repositioning, temporomandibular joint mobilization, and acupuncture, and innovatively introduces modern rehabilitation fascial chain theory, proposing a rehabilitation exercise system of “lower limb drive, core stability, cranio-mandibular linkage”. Through combined local and distal functional exercise guidance, it aims to rebuild occlusal biomechanical balance, improve clinical efficacy, and reduce recurrence rates.