邝高艳 卢敏 严可 卢芳国 吴泳蓉 龚志贤 邝涛

摘要 随着我国社会人口老龄化及慢性劳损的增加，慢性骨关节疾病发病率呈上升趋势，已成为影响中老年人群健康及生命质量的重要因素。“治未病”思想是中医学的特色和精华内容，将其预防疾病思想与慢性骨关节疾病的防治结合起来具有显著的现实意义。湖南中医药大学第一附属医院骨伤科经过30多年临床经验的总结，在慢性骨关节疾病防治方面形成了一套完整的三级防治体系，提出“未病先防”三联预防;“既病防变”改善症状，延缓退变，强调及时诊治，以防他变;“术后复健”强调指导康复、预防并发症。采取中西医结合防治体系恢复关节功能和身心健康，对临床防治慢性骨关节疾病具有重要的参考价值。

关键词 慢性骨关节疾病;“治未病”思想;综合治疗;预防;医教合作;医护合作;医患合作;医工合作

Abstract With the aging of social population and the increase of chronic strain，the incidence of chronic osteoarticular diseases is on the rise，which has become an important factor affecting the health and quality of life of middle-aged and elderly people.The theory of “preventive treatment of disease” is the characteristic and essence of the academic thought of Traditional Chinese medicine（TCM）.It is of great practical significance to combine the preventive idea with the prevention and treatment of osteoarthritis.The Department of Orthopedics of the First Hospital of Hunan University of Chinese Medicine which already have more than 30 years of clinical experience，concluded that the prevention and treatment of chronic osteoarticular diseases formed a complete three-level prevention and treatment system-“prevention before disease” triple prevention，“prevention from changes after diagnosis” to improve symptoms and delay degeneration，emphasizing timely diagnosis and treatment to prevent its change，and “postoperative rehabilitation” emphasizing guiding rehabilitation，prevention of complications，and adopting integrated Chinese and Western medicine prevention and treatment system to restore joint function and physical and mental health.This three-level system has important reference value for clinical prevention and treatment of chronic osteoarticular diseases.

Keywords Chronic osteoarthropathy; “Preventive treatment of disease” theory; Comprehensive treatment; Prevention; Medical-teaching cooperation; Medical-caring cooperation; Doctor-patient cooperation; Doctor-worker cooperation

中圖分类号：R274.3;R274.9文献标识码：Adoi：10.3969/j.issn.1673-7202.2021.10.026

慢性骨关节疾病是中老年人常见疾病，主要是由于人体自然退变，并因创伤、劳损、感受外邪、代谢障碍等因素导致全身和局部的疼痛、肿胀、麻木、肌肉萎缩、活动受限等症状体征的综合征[1-3]。目前国内外对骨关节炎的药物治疗多以缓解症状为目的，因此如何更好地防治慢性骨关节疾病，成为当前医学研究的热点，本病不仅作为医学问题，而且也成为社会问题，日益引起人们的重视;同时，也是对骨科医生的一大挑战[4-5]。“治未病”思想是中医学的特色和精华，在慢性病的防治中具有重要指导价值[6-8]。……