名医论证之膝骨性关节炎戎洋：站得直方能行得远
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font-size: 16px; letter-spacing: 0.578px; white-space: normal; background-color: rgba(234, 85, 35, 0.05); -webkit-tap-highlight-color: transparent; outline: 0px; text-indent: 2.25em; visibility: visible;"><span style="-webkit-tap-highlight-color: transparent; outline: 0px; color: #81100a; visibility: visible;"><strong style="-webkit-tap-highlight-color: transparent; outline: 0px; visibility: visible;"> </strong></span></p><p style="margin-bottom: 0px; font-size: 16px; letter-spacing: 0.578px; white-space: normal; background-color: rgba(234, 85, 35, 0.05); -webkit-tap-highlight-color: transparent; outline: 0px; text-indent: 2.25em; visibility: visible;"><span style="font-size: 16px;"><span style="-webkit-tap-highlight-color: transparent; outline: 0px; color: #81100a; visibility: visible;"><strong style="-webkit-tap-highlight-color: transparent; outline: 0px; visibility: visible;">本期口述</strong></span><strong style="-webkit-tap-highlight-color: transparent; outline: 0px; letter-spacing: 0.578px; color: #81100a; text-indent: 2.25em; visibility: visible;">——骨伤科（一）主任 戎洋</strong></span></p><p style="margin-bottom: 0px; font-size: 16px; letter-spacing: 0.578px; white-space: normal; background-color: rgba(234, 85, 35, 0.05); -webkit-tap-highlight-color: transparent; outline: 0px; text-indent: 2.25em; visibility: visible;"><span style="font-size: 16px;"><strong style="-webkit-tap-highlight-color: transparent; outline: 0px; letter-spacing: 0.578px; color: #81100a; text-indent: 2.25em; visibility: visible;">本期整理——徐晋</strong></span></p><p style="margin-bottom: 0px; font-size: 16px; letter-spacing: 0.578px; white-space: normal; background-color: rgba(234, 85, 35, 0.05); -webkit-tap-highlight-color: transparent; outline: 0px; text-indent: 2.25em; visibility: visible;"><span style="font-size: 16px;"><strong style="-webkit-tap-highlight-color: transparent; outline: 0px; letter-spacing: 0.578px; color: #81100a; text-indent: 2.25em; visibility: visible;">本期病症——膝骨性关节炎</strong></span></p><p style="margin-bottom: 0px; font-size: 16px; letter-spacing: 0.578px; white-space: normal; background-color: rgba(234, 85, 35, 0.05); -webkit-tap-highlight-color: transparent; outline: 0px; text-indent: 2.25em; visibility: visible;"> </p><section style="margin-top: 4px; margin-bottom: 4px; letter-spacing: 0.578px; white-space: normal; font-family: mp-quote, -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; font-size: 16px; -webkit-tap-highlight-color: transparent; outline: 0px; text-align: left; justify-content: flex-start; display: flex; flex-flow: row;"><section style="padding: 20px; -webkit-tap-highlight-color: transparent; outline: 0px; display: inline-block; width: 656.997px; vertical-align: top; background-color: #f3f8ff; align-self: flex-start; flex: 0 0 auto;"><section style="padding-right: 10px; padding-left: 10px; -webkit-tap-highlight-color: transparent; outline: 0px; text-align: justify; line-height: 2; letter-spacing: 2px;"><section class="js_underline_content" style="-webkit-tap-highlight-color: transparent; outline: 0px; letter-spacing: 0.578px; z-index: 0; visibility: visible;"><section style="-webkit-tap-highlight-color: transparent; outline: 0px; color: var(--weui-fg-half); visibility: visible;"><section style="margin: 10px auto; -webkit-tap-highlight-color: transparent; outline: 0px; visibility: visible;"><section style="margin-top: -24px; padding: 1em; -webkit-tap-highlight-color: transparent; outline: 0px; background-image: url('https://pic.app.fy169.net/FnMq9ywaDmkF7OkEVSxFrwVVB9wB'); background-repeat: repeat; background-attachment: initial; background-origin: initial; background-clip: initial; background-size: 100%; background-position: center top; visibility: visible; border: 4px solid #51cbbb;"><section style="-webkit-tap-highlight-color: transparent; outline: 0px; font-size: 14px; letter-spacing: 1.5px; visibility: visible;"><p style="text-align: center;"><img class="rich_pages wxw-img js_insertlocalimg" style="height: 267px; width: 208px;" src="https://pic.app.fy169.net/FnM0GZrWWtgfngL517cL8DZGvZOf" /></p><section style="-webkit-tap-highlight-color: transparent; outline: 0px; text-align: center; color: #444444; font-size: 16px; letter-spacing: 0.544px; background-color: #def5fd; line-height: 2em; font-family: system-ui, -apple-system, BlinkMacSystemFont, Arial, sans-serif;"><p> </p><section style="line-height: 2em;"><span style="letter-spacing: 2px;"><strong><span style="font-size: 16px;">戎洋</span></strong></span></section><section style="line-height: 2em;"><span style="letter-spacing: 2px;"><strong><span style="font-size: 16px;">骨伤科（一）主任</span></strong></span></section><section style="line-height: 2em;"><span style="letter-spacing: 2px;"><strong><span style="font-size: 16px;">主任医师</span></strong></span></section><p> </p></section></section></section></section></section></section></section></section></section><section style="margin-bottom: 0px; color: var(--weui-fg-half); letter-spacing: 0.578px; white-space: normal; font-family: mp-quote, -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; font-size: 16px; -webkit-tap-highlight-color: transparent; outline: 0px;"><section style="-webkit-tap-highlight-color: transparent; outline: 0px;"><section style="-webkit-tap-highlight-color: transparent; outline: 0px; text-align: left; justify-content: flex-start; display: flex; flex-flow: row;"><section style="padding-right: 5px; padding-left: 5px; -webkit-tap-highlight-color: transparent; outline: 0px; display: inline-block; vertical-align: bottom; width: 65.6944px; flex: 0 0 auto; height: auto; align-self: flex-end;"><section style="-webkit-tap-highlight-color: transparent; outline: 0px; transform: perspective(0px); transform-style: flat;"><section style="-webkit-tap-highlight-color: transparent; outline: 0px; text-align: center; transform: rotateX(180deg); line-height: 0;"></section></section></section></section><section style="margin-bottom: 10px; letter-spacing: 0.578px; -webkit-tap-highlight-color: transparent; outline: 0px; text-align: center; line-height: 0; visibility: visible;"></section><section class="js_underline_content" style="letter-spacing: 0.578px; -webkit-tap-highlight-color: transparent; outline: 0px; z-index: 0; visibility: visible;"><section style="-webkit-tap-highlight-color: transparent; outline: 0px;"><section style="padding: 10px; -webkit-tap-highlight-color: transparent; outline: 0px;"><section style="margin-top: 20px; -webkit-tap-highlight-color: transparent; outline: 0px; color: var(--weui-fg-half); display: flex; flex-flow: row; text-align: left; justify-content: flex-start;"><section style="margin-right: 10px; margin-left: 10px; -webkit-tap-highlight-color: transparent; outline: 0px; display: inline-block; width: auto; vertical-align: top; flex: 100 100 0%; align-self: flex-start; height: auto; line-height: 0; border-width: 0px;"><section style="-webkit-tap-highlight-color: transparent; outline: 0px; text-align: justify; justify-content: flex-start; display: flex; flex-flow: row;"><section style="-webkit-tap-highlight-color: transparent; outline: 0px; display: inline-block; width: 636.997px; vertical-align: top; background-color: #e3efff; align-self: flex-start; flex: 0 0 auto;"><section style="-webkit-tap-highlight-color: transparent; outline: 0px; display: flex; flex-flow: row; text-align: right; justify-content: flex-end;"><section style="-webkit-tap-highlight-color: transparent; outline: 0px; display: inline-block; vertical-align: middle; width: auto; flex: 100 100 0%; height: auto; align-self: center;"><section style="padding-right: 20px; padding-left: 20px; -webkit-tap-highlight-color: transparent; outline: 0px; font-size: 20px; text-align: left; line-height: 0;"><p style="-webkit-tap-highlight-color: transparent; outline: 0px;"><span style="font-size: 16px;"><strong style="-webkit-tap-highlight-color: transparent; outline: 0px;">专家简介</strong></span></p></section></section><section style="-webkit-tap-highlight-color: transparent; outline: 0px; display: inline-block; vertical-align: middle; width: auto; flex: 0 0 auto; align-self: center; min-width: 10%; height: auto;"><section style="-webkit-tap-highlight-color: transparent; outline: 0px; text-align: center;"><section style="-webkit-tap-highlight-color: transparent; outline: 0px; display: inline-block; width: 23px; height: 6px; vertical-align: top; overflow: hidden; border-radius: 30px; background-color: #ffffff; border: 1px solid #ffffff;"></section></section></section><section style="-webkit-tap-highlight-color: transparent; outline: 0px; display: inline-block; vertical-align: middle; width: auto; min-width: 10%; flex: 0 0 auto; height: auto; align-self: center;"><section style="-webkit-tap-highlight-color: transparent; outline: 0px; text-align: center;"><section style="-webkit-tap-highlight-color: transparent; outline: 0px; display: inline-block; width: 6px; height: 6px; vertical-align: top; overflow: hidden; border-radius: 30px; background-color: #ffffff; border: 1px solid #ffffff;"></section></section></section></section></section></section></section></section><section style="-webkit-tap-highlight-color: transparent; outline: 0px; text-indent: 0em; line-height: 2em;"><section style="margin-top: 4px; margin-bottom: 4px; -webkit-tap-highlight-color: transparent; outline: 0px; justify-content: flex-start; display: flex; flex-flow: row;"><section style="padding: 20px; -webkit-tap-highlight-color: transparent; outline: 0px; display: inline-block; width: 656.997px; vertical-align: top; background-color: #f3f8ff; align-self: flex-start; flex: 0 0 auto;"><p style="margin-bottom: 2px; -webkit-tap-highlight-color: transparent; outline: 0px; color: #000000; text-indent: 2.25em;"><span style="text-indent: 0em; color: var(--weui-fg-half); letter-spacing: 2px;">2005年毕业于蚌埠医学院临床医学专业，主持及参与市级科研课题两项，发表论文两篇，论著两部。安徽省医师协会运动医学医师分会第一届委员会委员，安徽省康复医学会运动创伤与关节镜外科专业委员会委员，安徽省全科医师协会骨科分会第一届理事会常务理事，阜阳市医学会骨科学常务委员，阜阳市医学会创伤医学分会第二届委员会常务委员，阜阳市中医学会骨伤科分会副主任委员，第三批“阜阳市高层次专业技术后备人才”。曾先后于南京鼓楼医院、安徽医科大学第一附属医院、中国科学技术大学附属第一医院进修学习。</span></p><p style="margin-bottom: 2px; -webkit-tap-highlight-color: transparent; outline: 0px; color: #000000; text-indent: 2.25em;"><span style="text-indent: 0em; color: var(--weui-fg-half); letter-spacing: 2px;">擅长：创伤致脊柱脊髓损伤及脊柱退行性疾病的诊治（如颈椎病、腰椎间盘突出症、腰椎管狭窄症、脊柱椎体压缩性骨折等）；人工髋、膝关节置换；运动创伤性疾病的关节镜微创治疗；对四肢创伤及多发性骨折的诊治等具有丰富临床经验。</span><span style="font-size: 17px; letter-spacing: 2px; text-indent: 2em; background-color: rgba(234, 85, 35, 0.05); color: rgba(0, 0, 0, 0.9); font-family: mp-quote, PingFang SC, system-ui, -apple-system, BlinkMacSystemFont, Helvetica Neue, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif;"> </span></p></section></section></section></section></section></section></section></section><p style="line-height: 2em; text-indent: 2em;"><strong><span style="letter-spacing: 2px;">膝骨性关节炎概念、流行病学、病因病机及主要临床症状</span></strong></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">膝关节炎主要指膝关节骨性关节炎</span><span style="letter-spacing: 2px; text-indent: 2em;">（knee osteoarthritis,KOA）。</span><span style="letter-spacing: 2px; text-indent: 2em;">该病是一种以膝关节软骨退行性病变和继发性骨质增生为特征的慢性关节疾病，膝关节炎症状往往进展缓慢，随着时间推移逐渐出现膝关节疼痛、肿胀、僵硬、畸形等，导致患者不能灵活活动，严重者可完全无法行动。</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">我国膝关节症状性骨关节炎的患病率为8.1%，45岁以下人群患病率较低为1%~4%。65岁以上人群患病率约为50%，75岁以上人群患病率高达80%。对于轻型患者，男女发病无明显差别，对于60岁以上重型患者，女性发病率高于男性。</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">膝关节炎病因和发病机制尚不明确，目前认为其发病与年龄、肥胖、炎症、创伤及遗传因素等有关，其特征是膝关节软骨原发性或继发性退行性变及骨质增生。</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">膝关节炎典型症状有：关节疼痛、关节活动受限、关节肿胀、关节畸形、骨摩擦感（音）、肌肉萎缩。</span></p><p style="text-align: center;"><img class="rich_pages wxw-img js_insertlocalimg" src="https://pic.app.fy169.net/FqmUmHw5DadHI5AxnLZMrmrXomxs" /></p><p style="line-height: 2em; text-indent: 2em;"><strong><span style="letter-spacing: 2px;">膝骨性关节炎诊断标准：</span></strong></p><p style="text-align: center;"><img class="rich_pages wxw-img js_insertlocalimg" src="https://pic.app.fy169.net/Fi5OSl1rho4bhEwZ0OOSPEWmo0mm" /></p><p style="line-height: 2em; text-indent: 2em;"><strong><span style="letter-spacing: 2px;">膝骨性关节炎常用分型</span></strong></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">1.按病理进展分型</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">(1) 早期（软骨退化期）</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">症状：偶发膝关节酸痛，久坐/晨起僵硬（<30分钟），活动后缓解。</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">影像学：X线显示关节间隙轻度狭窄，软骨下骨硬化。</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">(2) 中期（骨赘形成期）</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">症状：持续疼痛，活动受限（上下楼梯、蹲起困难），可能出现关节弹响。</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">影像学：明显骨赘（骨刺）、关节间隙变窄、软骨下囊性变。</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">(3) 晚期（关节畸形期）</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">症状：静息痛、夜间痛，关节变形（如内翻膝）、活动能力丧失。</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">影像学：关节间隙消失，骨赘增大，严重骨质硬化。</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">2. 特殊分型（基于MRI或关节镜）</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">软骨损伤分级（Outerbridge分级）：</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">Ⅰ级：软骨软化</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">Ⅱ级：部分厚度裂痕</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">Ⅲ级：全层裂痕未达骨面</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">Ⅳ级：软骨全层缺损，骨质暴露</span></p><p style="text-align: center;"><img class="rich_pages wxw-img js_insertlocalimg" src="https://pic.app.fy169.net/FvDQCYIKhnAnnTNP4aJtn5SSS8ZO" /></p><p style="line-height: 2em; text-indent: 2em;"><strong><span style="letter-spacing: 2px;">膝骨性关节炎如何治疗：</span></strong></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">戎主任指出不能忽视中医在膝骨性关节炎治疗中的作用，根据患者的具体症状和证型区别，分别可以给予中药封包、艾灸、针灸、穴位推拿与贴敷、针刀等治疗手段。西医治疗原则是根据患者病情进行梯度化、个性化治疗，分为基础治疗、药物治疗、修复性治疗和重建治疗四个层次：</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">底层治疗：底层为基础治疗，包括进行患者教育、运动治疗、物理治疗、行动辅助治疗、适用于所有骨关节炎患者；早期患者，依据患者的需求和一般情况，可选择适宜的基础治疗方案。</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">第二层治疗：患者病情加重，进行个体化、阶梯化的药物治疗。按药物使用途径分为外用药物、口服药物、肛门栓剂、静脉输入、关节腔内注射药物。药物作用范围分为局部用药和全身用药。药物包括镇痛药物治疗、关节腔注射药物治疗、缓解症状的慢作用药物、中成药治疗。在考虑患者发病的部位及自身危险因素的基础上，选择正确的用药途径及药物种类。</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">第三层治疗：病情进一步加重，在基础治疗和药物治疗都无效的前提下进行膝关节修复性治疗，包括以及富血小板血浆（PRP）、关节镜手术、软骨修复手术、力线矫正手术、膝关节周围截骨术等。治疗方案需依据患者病变部位、病变程度、一般情况以及自身意愿综合考虑。</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">第四层治疗：患者病情严重，手术修复性治疗无效时进行手术关节重建治疗，包括关节置换术、关节融合术等。手术重建治疗为终末期膝关节炎治疗的有效方案，能有效缓解关节疼痛，回复关节活动功能。</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">我科自建科以来收治膝关节炎患者已达数千例，对于不同患者，我科会根据病情轻重缓急选择不同层次的治疗方式，严格遵循膝骨性关节炎的治疗原则，采用中西医结合的方式，均取得了不错的疗效。</span></p><p style="text-align: center;"><img class="rich_pages wxw-img js_insertlocalimg" src="https://pic.app.fy169.net/FllNZo4YpBx-qHZ2MRbIKoSATwmw" /></p><p style="line-height: 2em; text-indent: 2em;"> </p><p style="text-align: center;"><img class="rich_pages wxw-img js_insertlocalimg" src="https://pic.app.fy169.net/FoGdc1ve25IVfnWFmlrOOe-77B3Q" /></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px; text-indent: 2em;">关节镜下膝骨性关节炎表现如上图（白色箭头为关节软骨剥脱，黑色箭头为软骨下骨裸露）</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">膝关节置换术后X线片见下图：</span></p><p style="text-align: center;"><img class="rich_pages wxw-img js_insertlocalimg" src="https://pic.app.fy169.net/FmG6toxZRS9NWM1NDhXDvpEN9bOR" /></p><p style="line-height: 2em; text-indent: 2em;"><strong><span style="letter-spacing: 2px; text-indent: 2em;">膝骨性关节炎如何预防：</span></strong></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">一、体重管理：减轻关节负荷</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">核心建议：BMI控制在18.5-23.9【BMI=体重（kg）/身高（m）2】</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">体重每减少5kg，膝关节炎风险降低50%。</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">执行方案：</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">低GI饮食（如全谷物、绿叶蔬菜）</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">避免高嘌呤食物（如动物内脏）以减少炎症反应</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">二、科学运动：强化肌肉与保护软骨</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">1.低冲击有氧运动</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">推荐游泳、骑自行车（阻力调低）、快走</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">禁忌：爬楼梯、登山、深蹲等加重关节磨损的活动</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">2.股四头肌强化训练</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">直腿抬高训练：仰卧位伸直下肢抬高30°，保持10秒，10次/组静蹲改良法靠墙屈膝角度≤30°，避免髌股关节压力过大</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">3.灵活性训练</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">太极拳（改良式）：可改善关节本体感觉</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">三、关节保护：减少日常损伤</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">姿势调整：</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">避免久坐久站，每30分钟变换体位</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">如厕建议使用坐便器，减少蹲起动作</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">辅助工具：</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">必要时使用手杖（健侧持杖可减少患膝20%负荷）</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">选择软底缓冲鞋（如硅胶鞋垫），避免穿高跟鞋</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">四、营养干预：针对性补充</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">维生素D：血清25(OH)D需≥30ng/ml</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">Omega-3脂肪酸：每日1.2g（三文鱼、亚麻籽）可抑制炎症因子IL-1β</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">争议性补充剂：</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">硫酸氨基葡萄糖：指南认为可能对早期患者有效（需持续3个月以上）</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">胶原蛋白：分析显示Ⅱ型胶原蛋白可能缓解疼痛</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">五、中医养生：传统医学的应用</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">艾灸疗法：艾灸犊鼻穴（膝眼）可改善局部微循环</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">中药熏洗：推荐方：威灵仙30g+红花15g+海桐皮20g水煎外敷</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">六、高风险人群早期筛查</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">建议以下人群定期检查：</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">40岁以上+家族史</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">关节外伤史（如前交叉韧带损伤、半月板损伤）</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">长期从事重体力劳动或运动员</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">筛查手段：</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">超声检查（动态观察滑膜增生）</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">磁共振（MRI）评估软骨分层情况</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">特别提醒</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">避免误区：</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">热敷适用于慢性疼痛，急性肿胀期应冰敷</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">盲目补钙无法修复软骨，过量可能加重血管钙化</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">阶梯化预防：</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">30-40岁：侧重运动强化</span></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">50岁后：加强营养+关节功能监测</span></p><p style="line-height: 2em; text-indent: 2em;"><strong><span style="letter-spacing: 2px;">结语：</span></strong></p><p style="line-height: 2em; text-indent: 2em;"><span style="letter-spacing: 2px;">膝骨性关节炎以其较高的发病率以及疼痛、畸形等症状困扰着广大患者，膝骨性关节炎虽无法完全逆转，但通过科学管理，中西医结合辨证论治，个体化精准治疗，绝大多数患者可实现无痛行走、延缓手术的目标。衷心希望广大患者都能“站得直，行得远”，重视膝骨性关节炎，从控制体重、科学运动做起，如病痛不能缓解，请及时就医，阜阳市中医医院骨伤科（一）将为您提供科学、有效的康复及治疗方案。</span></p></section></section></section><section style="font-size: 16px; letter-spacing: 0.578px; -webkit-tap-highlight-color: transparent; outline: 0px; line-height: 0; text-align: center; transform: rotateY(180deg); visibility: visible;"><section style="-webkit-tap-highlight-color: transparent; outline: 0px; vertical-align: middle; display: inline-block; line-height: 0; width: 676.997px; height: auto; visibility: visible;"><img class="rich_pages wxw-img" style="vertical-align: middle; -webkit-tap-highlight-color: transparent; outline: 0px; width: 676.906px !important; visibility: visible !important;" src="https://pic.app.fy169.net/FpTS8bQvNkuso2HaCkgKmZnje-RV" alt="图片" width="100%" /></section></section></section></section><section><section><p><img class="rich_pages wxw-img" src="https://pic.app.fy169.net/FtXsl0QVH9jG5E--4wCcKPbJEyml" /></p><p><img class="rich_pages wxw-img" src="https://pic.app.fy169.net/FjUOV3_mfwG-yRMAQL6hp6okBBet" /></p><p><img class="rich_pages wxw-img" src="https://pic.app.fy169.net/FkmdrvgyFawr-_cg4YVFKR8-s_V8" /></p></section></section></section></section><p style="display: none;"> </p> <!----></div> 好医术
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