摘要
膝痹病(膝骨关节炎)(KOA)多发于40岁以上的中老年人,而该病最终致残率为53%。基于循证医学制定的KOA中医临床实践指南具有极其重要的意义,有助于规范中医药临床诊疗技术,取得更好的疗效。本指南体现了辨证论治的特色和优势,内容主要基于循证医学原则及中医文献依据分级标准并结合专家共识、专家论证、同行征求意见、临床评价等,按照临床诊疗指南编写规则编写。本指南从范围、术语和定义、诊断、辨病分期与辨证分型、治疗等方面对KOA的诊疗流程进行了规范,旨在为中医骨伤科、中西医结合骨科、中医科、针灸科、推拿科、风湿免疫科、康复科等相关临床医师提供诊疗指导和参考。治疗部分指出KOA的治疗原则,分为非药物治疗、药物治疗及手术治疗3个部分,并阐述各种治疗方法的适应证及推荐级别。非药物治疗部分主要有健康教育、练功、手法、针灸、针刀、理疗及器具等疗法;药物治疗部分则分别从外用药、注射药、中药辨证论治、中成药、控制症状的口服药、骨关节炎慢作用药(DMOAD)及软骨保护剂方面展开论述;手术治疗部分主要包括关节镜手术、截骨术、人工关节置换术、关节融合术等。本指南具有较好的临床适用性、安全性及有效性。
Knee osteoarthritis (KOA, Xibibing) is a common disease in people over 40, and the disability rate is 53%. Based on evidence-based medicine, the clinical practice guidelines of traditional Chinese medicine (TCM) for Xibibing (KOA), it is necessary to standardize TCM clinical diagnosis and treatment technology. The characteristics and advantages of syndrome differentiation and treatment are reflected in the development of TCM clinical diagnosis and treatment guidelines for Xibibing (KOA). This guidance is mainly based on the principle of evidence-based medicine and TCM literature and the expert consensus, the expert argumentation, peer opinions, clinical evaluation, etc. The guidance includes terms and definitions, diagnosis, classification of the disease stages and syndrome differentiation, treatment of the disease (KOA), for the treatment of traumatology, combine traditional Chinese and western medicine orthopedics, Chinese medicine, acupuncture, massage, rehabilitation and rheumatism clinicians. The treatment section for Xibibing (KOA) is divided into three, non-drug treatment, drug treatment and surgical treatment, and describes the indications and recommended levels of various treatment methods. Non-drug treatment mainly includes health education, skill training, manipulation, acupuncture and moxibustion, acupotomology, physiotherapy and other therapies. In the drug treatment part, it is discussed from the aspects of external medicine, injection medicine, syndrome differentiation and internal treatment of traditional Chinese medicine, Chinese patent medicine, oral medicine for symptom control, diseases modifying osteoarthritis drugs (DMOAD) and cartilage protectant. Surgical treatment includes arthroscopic surgery, osteotomy, artificial joint replacement and arthrodesis. The guideline is of importance for clinical applicability, safety and effectiveness.
作者
无
陈定家
刘军
CHEN Dingjia;LIU Jun(Working Group on Setting up Guidelines for Diagnosis and Treatment of Knee Osteoarthritis (Xibibing) in Orthopedics Section of China Association of Chinese Medicine)
出处
《康复学报》
CSCD
2019年第3期1-7,共7页
Rehabilitation Medicine
基金
国家中医药管理局中医临床诊疗指南制定项目(SATCM-2015-BZ[115])
关键词
膝痹病
膝骨关节炎
临床诊疗
中医骨伤科
指南
Xibibing
knee osteoarthritis
clinical diagnosis and treatment
orthopedics and traumatology of traditional Chinese medicine
guideline
