中医“护膝”有五法，远离疼痛好办法

中医“护膝”有五法，远离疼痛好办法

李平

成都平安医院中医科疼痛科 四川成都 610000

话说“人老先老腿”，故许多老年人常被膝痛所困扰，特别是季节更替时，膝关节痛反复难愈，影响日常行动，给生活带来极大不便。中医学认为，膝为“筋之府”。膝痛，责之于肝肾不足、风寒湿邪气外侵，属于中医学“膝部痹证”范畴，病位主要在筋、骨，涉及肉。治疗以滋补肝肾、行气活血、疏通经络为要。

一.中医穴位

1.1耳穴

耳穴选取肝、肾

当脏腑肢体发生病变时，通过耳穴体表内脏反射区及肝、肾耳穴埋豆（王不留行）按压起到滋补肝肾的作用。

1.2体位按穴

体位取穴：膝眼、鹤顶

膝眼位于膝盖骨下方两侧的凹陷中，内侧称内膝眼，外侧称外膝眼。鹤顶准确位置位于膝前区，髌底中点的上方凹陷中。取穴方法为屈膝，先找到髌底，即膝盖前面中央髌骨的上缘，在其中点上方凹陷处，即为鹤顶穴。

局部穴位指压，以酸胀感为度。达到行气活血、疏通经络，止痛功效。

2.3艾灸取穴：阳陵泉

阳陵泉穴位于膝盖斜下方，小腿外侧之腓骨小头稍前凹陷中。阳陵泉为筋会，胆经穴。《灵枢·邪气藏府病形篇》“筋急，阳陵泉主之”。选择午时阳气盛时艾灸，以温筋通络。

2.4 揉中渚穴

对于反复发作的膝盖疼痛，可行“下病论治”，按中渚穴。中渚穴在于手背，小指和无名指根部下方两cm、手背凹陷处，全力按压，出现力量感减弱的感觉。

中渚穴即三焦经的“俞穴”，是缓解疼痛的必备穴位。《难经》提到：“俞，主体重节痛”。膝盖疼痛也在它的管辖范围内，平时按中渚穴，可缓解关节疼痛。

2.5、急性损伤按梁丘

梁丘穴在膝盖骨上2寸，股外侧肌与骨直肌肌腱之间。

属于胃经“郄穴”，擅长调治多种急性病，可快速调节胃气血盈亏状态，对于急性胃痛、胃酸、乳房痛、肠胃炎等本经之病起到治疗作用，亦对急性腿痛、脚痛、膝盖痛起到根治效果。

二.药膳治疗

药膳材料

1：黄耆5钱、何首乌3钱、杜仲3钱、当归3钱、威灵仙3钱、干姜5钱、黑豆5钱、淮牛膝3钱、猪蹄一段约200克做法：将猪蹄清洗、切块后，所有材料放入锅中，并加入适量的水熬煮，待到猪蹄煮得熟软后，猪蹄肉连同汤一起食用。

2：冬瓜500克、薏苡仁（薏米）100克、生姜2片、排骨300克做法：冬瓜洗净后，不去皮、去籽、切块；猪排骨洗净，斩块；薏米掏净。将排骨先用沸水焯水，焯水后洗净血污，放入锅中加清水适量煮开，撇去浮沫，然后下冬瓜、薏米、生姜，约1个小时煮至排骨、冬瓜熟后，加入油盐调味。食肉饮汤，每周2次。有效缓解因湿热痹阻的膝关节红、肿、热、痛、屈伸不利等不适。

3.中药材料：苏叶9克，吴茱萸9克，桔梗9克，木瓜15克，陈皮6克，槟榔10克，生姜3片。水煎服，每日一剂，10剂为一疗程。

三. 热敷治疗：独活3钱、羌活3钱、细辛3钱、骨碎补3钱丶桂枝3钱丶鸡血藤3钱丶老姜3钱做法：将中药材放入布袋并微波加热2分钟，或是所有药材加水适量熬煮、再将毛巾泡入水中、拧干，皆可外敷在膝盖或患部。每天可热敷2~3回、每次10~15分钟。

四.膝关节保健操

直抬腿仰卧，双腿自然伸直。在膝关节伸直后，向上抬起 15 度，保持这一姿势，坚持 3 分钟。休息 2 分钟后再次重复。每天完成 15 次至 20 次即可。膝关节屈伸仰卧，双腿和膝关节同时进行屈伸动作，提高肌肉和韧带的弹性、韧性和关节柔韧性，消除膝关节无菌性炎症，避免膝关节周围软组织粘连；2-3次/d，每次至少3分钟。拍打练习：张开双手，放于膝关节两侧，放松手腕关节，用力拍打膝关节，引起皮肤疼痛和关节震动。

五.养生功法

养生技术是中国传统医学的一大特色，即太极拳、五禽戏、易筋经、八段锦、站桩功等，动作保持轻柔，适合各个年龄段，尤其中老年人。其中，太极拳和站桩功均可增强下肢肌肉力量，加强膝关节控制，稳定膝关节，从而减轻疼痛，扼制病情发展。

总结                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   

在日常生活中要做好膝盖的保暖工作，轻缓运动，运动时候注意不要猛动。运动过后，给自己按摩，起到舒筋活血的作用。

作者简介：李平，1985.11.18，女，重庆奉节，汉，本科，研究方向：膝关节病的针灸及中药治疗，主治医师，