膝骨关节炎(knee osteoarthritis,KOA)是临床上常见的退行性骨关节疾病,目前临床上尚缺乏能够有效遏制其进展的治疗方法.间充质干细胞来源外泌体(mesenchymal stem cell-derived exosome,MSC-EXO)在KOA软骨损伤修复中具有显著的优势,关节腔注射MSC-EXO有望成为治疗KOA的重要疗法.本文对MSC-EXO进行了概述,并从抑制软骨细胞外基质降解、调控软骨细胞增殖与凋亡、抑制炎症反应和增强软骨细胞自噬等方面,对MSC-EXO修复KOA软骨损伤作用机制的研究进展进行了综述.

在科技进步的今天,颈椎病患者逐渐增多,其中颈型颈椎病患病人群以长期伏案工作者居多,颈型颈椎病的发病与人们的生活作息息息相关,稍不注意就会出现颈肩部不适、头晕、头痛等症状.中医养生功法具有改善微循环、加速新陈代谢的作用,在颈型颈椎病的预防与治疗中具有一定的优势.中医养生功法包括五禽戏、八段锦、易筋经、太极拳、导引术等,这些养生功法操作简单,并且易于施行.本文将通过对中医养生功法在颈型颈椎病的治疗和预防方面的临床研究进行概述,以期为中医养生功法治疗颈型颈椎病提供理论基础,造福广大患者朋友,发扬中国传统文化.中医养生功法治疗颈型颈椎病机制阐述研究尚未完全清楚,今后应在其作用机制研究与落地推广上进一步加强.

膝骨关节炎作为灸法的高频运用病症,在其临床治疗上,各类灸法均得到了广泛应用,分别为单纯艾灸、温针灸、麦粒灸、雷火灸、热敏灸、隔物灸及灸法综合治疗等方法.文中对近年来灸法治疗膝骨关节炎的研究状况作一简要综述.

骨关节病属于中医学"痹病"范畴,以关节疼痛和功能障碍为主要临床症状,严重影响人们的日常生活和工作.经筋刺法在经筋理论的指导下进行针刺治疗骨关节病取得了良好的临床疗效,文章阐述了经筋刺法在全身骨关节病中的临床应用,分析经筋刺法在骨关节疾病中的主要治疗方法及优势,使经筋疗法更好的在临床推广应用.

目的 总结平乐正骨平衡理论在肩周炎防治中的应用及经验,为该理论更好地应用于肩周炎的治疗提供理论支持.方法 通过临床观察及文献收集,并结合平乐正骨平衡理论的基本概念,将平乐正骨平衡理论在肩周炎防治中的应用进行总结.结果 平乐正骨平衡理论是平乐正骨流派在长期诊疗过程中不断丰富理论知识并结合临床经验总结出来的核心理论,主要包括天人合一、气血共调、筋骨并重、五脏协调、形神统一、标本兼顾、动静互补、膳食合理、起居有常等平衡理论.在防治肩周炎方面,平乐正骨平衡理论强调脏腑平衡、气血平衡、筋骨并重、动静结合,重视日常的养护,强调起居规律及膳食平衡.结论 平乐正骨以恢复机体平衡为原则,防治结合,以恢复脏腑、气血与内外的平衡,将平乐正骨平衡理论应用于临床防治中.

本文介绍了中药外敷、穴位贴敷、中药涂擦、中药熏洗、中医定向透药等中药外治法,在治疗膝骨关节炎方面均取得了良好的临床疗效.通过检索文献得知,中药外用治疗膝骨关节炎有多种方式,但同时也存在许多不足,今后应广泛开展膝骨关节炎的循证医学研究,并且要将四诊客观化的成果进一步纳入,实现中医疗法的推广应用.

髌股关节疼痛综合征是膝关节疼痛中最常见诊断之一,常见于运动人群,主要表现为上下楼梯、久坐、下蹲、跑、跳时加重,严重影响日常生活.本文介绍了中医和现代解剖学对髌股疼痛综合征的认识,目前对于该病的治疗主要采取运动疗法、针刺、手法、针刀、肌内效贴等,为临床研究提供参考.

中医治疗肩关节周围炎(以下简称肩周炎)的方法趋于多样化,中医疗法疗效显著,具有简、便、廉、验等优势.中医治疗肩周炎方法有中药、针刺、灸法、推拿、拔罐及小针刀等,兹将中医治疗肩周炎临床研究进展进行综述,以求临床研究的规范化和标准化.

膝骨关节炎(knee osteoarthritis,KOA)是一种以膝关节疼痛和运动障碍为主要表现的疾病,影响患者的身心健康和生活质量.经筋是维持膝关节稳定的重要构造之一,膝关节在病损过程中经筋会受到损伤,因此以经筋理论为指导依据治疗KOA有一定的探讨和应用价值.本文阐述了经筋是什么,经筋与KOA的关系,以及经筋疗法在KOA中的研究,以便更好地指导临床治疗.

Objective To observe the clinical efficacy and safety of Pingle bone-setting manipulation combined with acupuncture in the treatment of scapulohumeral periarthritis. Methods 62 cases of scapulohumeral periarthritis were divided into control group and observation group with 31 cases in each group according to the random number table.The control group was treated with acupuncture,and the observation group was treated with Pingle bone-setting manipulation combined with acupuncture.Both groups were treated with functional exercise,manipulation and acupuncture once a day,a total of 14 days.Functional exercise twice a day,5 minutes a time.The VAS score,shoulder joint capsule thickness,constant Murley shoulder joint function score before treatment,7 days after treatment and 14 days after treatment,as well as the clinical efficacy evaluation effect after 14 days of treatment were observed,followed up for 3 months,and adverse reactions were recorded.Results The VAS score and shoulder joint capsule thickness of the two groups were significantly decreased after 7 and 14 days of treatment（ P ＜0.05）,and the Constant-Murley shoulder joint score was significantly increased after treatment（ P ＜0.05）;There was no significant difference in VAS score and Constant-Murley shoulder function score between the control group and the observation group after 7 days of treatment（P＞0.05）;After 14 days of treatment,the VAS score and Constant-Murley shoulder function score in the observation group were better than those in the control group（P＜0.05）.After 7 and 14 days of treatment,there was no significant difference in the thickness of shoulder joint capsule between the two groups（P ＞0.05）,and the difference in the thickness of shoulder joint capsule in the observation group was greater than that in the control group（P ＜0.05）;The total effective rate of the observation group was 96.77%（30/31）after 14 days of treatment,which was significantly higher than that of the control group 87.09%（27/31）,P ＜0.05;There were no obvious adverse reactions in both groups during the treatment;After 3-month follow-up,the recurrence rate of the control group was 19.35%（6/31）,and that of the observation group was 9.67%（3/31）.The recurrence rate of the observation group was significantly lower than that of the control group.The difference was statistically significant（ P ＜0.05）.Conclusion Pingle bone-setting manipulation combined with acupuncture in the treatment of scapulohumeral periarthritis can effectively relieve pain and limited activity and other clinical symptoms,improve shoulder joint function,with high safety.

目前中医治疗肩周炎的方法趋于多样化,中医疗法疗效显著,具有"简、便、廉、验"等优势,得到广大患者的青睐.本文介绍了针刺和灸法对肩周炎的治疗.通过检索文献得知,关于针灸治疗肩周炎的相关临床研究较多,但是研究内容未提及健康教育及相关的注意事项,没有形成统一的标准与规范,不利于循证医学的开展.因此,今后应广泛开展循证医学研究,并且加强健康教育的宣传,以求临床研究的规范化和标准化.

目的:通过网络药理学和分子对接技术研究筋骨痛消丸治疗髌骨软化症(chondromalacia patellae)的作用机制.方法:首先通过中药系统药理学数据库与分析平台(TCMSP)挖掘筋骨痛消丸中各种中药的活性成分并预测其作用靶点,TCMSP数据库中缺失的中药利用文献检索与Swiss Target Prediction数据库获得有效成分及对应靶点.利用UniProt数据库,将获得的靶点蛋白的名称标准化.登录GeneCards、PharmGkb等数据库,获取髌骨软化症的疾病靶点.之后将药物靶点和疾病靶点取交集,制作出韦恩图.运用Cytoscape软件,筛选并构建"药物-活性成分-交集靶点-疾病"网络;利用String数据库构建蛋白互作(PPI)网络,并使用R语言对预测靶点进行GO富集分析和KEGG通路分析.最后通过Autodock软件对药物的主要活性成分和核心作用靶点进行分子对接验证.结果:研究结果显示筛选得到筋骨痛消丸治疗髌骨软化症的活性成分188个及靶点249个,主要活性成分为槲皮素、柚皮素、山奈酚、木犀草素、β-谷甾醇等,PPI网络主要计算出AKT1、CASP8、CASP3、JUN、BCL2L1、MYC等6个关键靶点.GO富集分析涉及生物过程(BP)1458个,细胞组分(CC)19个,分子功能(MF)65个;KEGG通路富集分析筛选得到43条与髌骨软化相关的通路,主要作用于脂质和动脉粥样硬化信号通路、细胞凋亡信号通路、AGE-RAGE信号通路以及病毒相关信号通路等.分子对接结果表明,药物组成中的主要活性化合物能够分别与代表性的靶点结合并展现出较好的亲和力.结论:本研究表明筋骨痛消丸治疗髌骨软化症涉及多条信号通路及生物学过程,其主要活性成分山奈酚、木犀草素、槲皮素与关键靶点AKT1、CASP3、MYC的结合可能是发挥作用的重要机制之一.

Objective To summarize the application of "Preventive treatment of disease" theory in the prevention and treatment of knee osteoarthritis,and provide theoretical support for the better application of this theory in the prevention and treatment of knee osteoarthritis. Methods Through clinical observation and literature collection,combined with the basic concept of the "Preventive treatment of disease" theory,the application of the concept of "Preventive treatment of disease" in the prevention and treatment of knee osteoarthritis was summarized. Results The theory of "Preventive treatment of disease" can be traced back to the Han Dynasty and has an important influence on the development of traditional Chinese medicine.In the process of development,the therapeutic concept of "revention before disease,prevention against change after disease and prevention of recurrence after recovery" has been formed,which plays a significant role in the prevention and treatment of knee osteoarthritis. Conclusion The application of the theory of "Preventive treatment of disease " to the clinical prevention and treatment of knee osteoarthritis is of great significance to integrate the prevention and treatment of knee osteoarthritis into daily life and promote the strategy of "great health",with the guiding principle of "giving priority to the prevention and treatment of bone disease before disease;combining the prevention and treatment of disease to prevent its transmission;strengthening the maintenance after recovery to prevent its recurrence".