从阳虚体质探讨经方分期辨治老年膝骨性关节炎OA

In clinical practice,combined with the characteristics of yang deficiency constitution in the elderly and traditional Chinese medicine(TCM)theories,early-stage knee osteoarthritis(KOA)in the elderly is located in the lung and defensive exterior.It is pathologically characterized by the invasion of wind,cold and dampness into the body surface as well as disharmony between nutrient and defensive qi.The treatment is mainly based on modified Guizhi decoction combined with Zhenwu decoction.In the middle and advanced stages,the disease is marked by yang deficiency of the spleen and kidney,blocked fu-qi of Yangming,and complicated with cold-dampness,phlegm-turbidity,static blood and other pathogenic factors.The therapeutic methods mainly adopt modified Jingui Shenqi pills combined with Xiaochengqi decoction,as well as modified Gancao Fuzi decoction combined with Dachaihu decoction.Particularly for middle and advanced KOA in elderly patients,this treatment put forward distinctive therapeutic principles as protecting the spleen and stomach,tonifying through purgation,treating via dredgence,and combining yang-warming with purgative therapy.It could significantly relieve knee joint pain,improve motor function,and block disease progression,which is worthy of further clinical research and application.