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基于局气论的难愈性溃疡中医诊治探索OA

Exploration of traditional Chinese medicine diagnosis and treatment for refractory ulcers based on local qi theory

中文摘要英文摘要

难愈性溃疡是临床常见的难治性疾病,其发病机制复杂,传统中医学认为与"阳化气不足,阴成形失常"密切相关.陆金根教授基于顾氏外科理论创新性提出局气论,强调局部气机失调是创面难愈的关键.该理论认为,局部之气的盛衰直接影响组织修复能力:阳气虚衰则局气推动无力,阴液失调则局气濡养失职,而湿热瘀毒等邪气又可阻滞局气运行,形成虚-瘀-毒的恶性循环.治疗应以调畅局气为核心,内治方面,益气温阳化瘀以振奋局气动力,滋阴养血濡润以充养局气基础,祛邪调气导滞以畅通局气通路;外治方面,创新性发展局部氧疗作为"现代补气法",首次公开团队局部氧疗规范化操作流程.

Refractory ulcers are common intractable clinical conditions with complex pathogenesis.Traditional Chinese medicine(TCM)attributes their pathogenesis to the"insufficiency of yang in transforming qi,and disorder of yin in forming substances".Professor Lu Jingen,building upon the theory of Gu's Surgery School,innovatively proposed the local qi(Juqi)theory,emphasizing that the dysfunction of local qi is a key pathological mechanism underlying refractory wound healing.This theory suggests that the fluctuation of local qi directly affects tissue repair ability:deficient yang leads to weak local qi movement,while imbalanced yin and fluids result in inadequate nourishment of local qi.Moreover,external pathogenic factors such as damp-heat,blood stasis and toxicity obstruct and block the flow of local qi,creating a vicious cycle of deficiency,stasis,and toxicity.The treatment should focus on regulating local qi.For internal treatment,the approach involves tonifying qi,warming yang,and resolving blood stasis to invigorate local qi,nourishing yin and blood to strengthen and moisten local qi,and expelling pathogenic factors while regulating qi and unblocking collaterals to restore the flow of local qi.For external treatment,the innovative development of local oxygen therapy as a"modern qi supplementation method"is introduced,with the research team also releasing the standardized procedure for local oxygen therapy for the first time.

陈利利;曹永志;李锋;陆金根

上海中医药大学附属龙华医院航头院区普外二科(上海 201317)上海杨思医院肛肠科(上海 200126)上海中医药大学附属龙华医院航头院区普外二科(上海 201317)上海中医药大学附属龙华医院航头院区普外二科(上海 201317)

难愈性溃疡慢性创面创面愈合中医药疗法局气论名医经验

refractory ulcerschronic woundwound surface healingtraditional Chinese medicine therapylocal qi theoryfamous doctor's experience

《上海中医药杂志》 2026 (2)

28-32,5

国家中医药管理局全国中医学术流派传承工作室第二轮建设项目(国中医药人教函[2019]62号)上海市卫健委上海市进一步加快中医药事业传承创新发展三年行动计划项目[ZY(2021-2023)-0209]

10.16305/j.1007-1334.2026.z20250505003

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