[摘要] 在中医治疗膝骨关节炎的理论与临床研究中，多从关节软骨退变为主要病理机制作为突破口，针刀疗法是中医治疗膝骨关节炎的常用手段，并且在临床上取得了较好的疗效，而关于经筋理论对针刀治疗本病的指导却少有涉及与研究。基于此，本文从经筋理论基本概念、经筋理论对膝骨关节炎病因病机的认识，以及指导如何选取针刀操作部位、如何临床运用针刀疗法等几个方面，就经筋理论对针刀治疗膝骨关节炎的指导意义这一问题进行了探讨。

[关键词] 经筋理论；膝骨关节炎；病因病机；针刀

[中图分类号] R683.42 [文献标识码] A [文章编号] 1673-7210（2016）11（c）-0165-04

Guiding significance of aponeurotic system theory for needle-knife in treating knee osteoarthritis

HE Haijun

The Third Department of Joint， Wangjing Hospital of China Academy of Chinese Medical Sciences， Beijing 100102， China

[Abstract] In the theory and clinical studies of traditional Chinese medicine in treating knee osteoarthritis， articular cartilage degeneration as the main pathological mechanism is usually taken to be the sally port， needle-knife therapy is the most common means of traditional Chinese medicine in treating knee osteoarthritis， which has achieved good effects in clinic， while there are less studies about the guidance of aponeurotic system theory for needle-knife in treating this disease. Thus， This paper discusses the guiding significance of aponeurotic system theory for needle-knife in treating knee osteoarthritis from the aspects of the basic conception of aponeurotic system theory， the understanding of aponeurotic system theory for the etiology and pathogenesis of knee osteoarthritis， and the guidance for how to choose operating position of needle-knife， how to use needle-knife therapy in clinic.

[Key words] Aponeurotic system theory； Knee osteoarthritis； Etiology and pathogenesis； Needle-knife

膝骨關节炎是中、老年人的常见病和多发病之一，在软骨退变的同时，也累及滑膜、关节囊、肌肉、肌腱、韧带、筋膜等其他组织[1-3]。基于这种病理学基础，现代医学对于早中期膝骨关节炎的治疗，大多通过肌力训练、关节镜清理以及镜下支持带的松解、髌下脂肪垫的成型以获得软组织平衡。祖国医学根据传统中医“膝为筋之府”“筋能束骨”“其留连筋骨之间者疼久”“痹在于筋则屈不伸”等经筋理论，认为膝骨关节炎发病除软骨下骨外，其他组织都归属于中医学“筋”的范畴。针刀治疗膝骨关节炎为中医的常用手段，其理论基础来自于经筋理论，通过松解膝关节周围的“筋”而获得软组织平衡，从而缓解疼痛，改善关节功能。近年来越来越多的学者基于经筋理论对针刀治疗膝骨关节炎的疼痛及功能障碍做了很多的研究[4-5]，并且取得了较好的疗效，基于此，笔者就经筋理论对针刀治疗膝骨关节炎的指导意义这一问题进行探讨。……