通讯作者: 吴官保, yhywgb@126.com

DOI：10.12201/bmr.202604.00074

Professor Wu Guanbao’s Experience in the Treatment of Spontaneous Osteonecrosis of the Knee Based on the Theory that “the Kidney Governs Bone and Generates Marrow”

• 摘要：膝关节自发性骨坏死以膝痛及负重功能障碍为主要表现，早期诊断多依赖磁共振成像，保守治疗尚存在疗程较长及结构保护不足等局限。本文基于《内经》“肾主骨髓”理论，结合临证经验，认为本病属本虚标实之证，以肾虚髓亏为本、络瘀骨痹为标，病位关键在软骨下骨—骨髓区。治疗当以补肾益髓、强筋壮骨为本，佐以活血通络止痛，并结合病程分期、证候演变灵活施治。验案显示，该法可减轻疼痛、改善膝关节功能，为膝关节自发性骨坏死的中医辨治提供参考。

  关键词： 膝关节自发性骨坏死；肾主骨髓；补肾益髓；名医经验; ; ; 

   

  Abstract: Spontaneous osteonecrosis of the knee is mainly characterized by knee pain and impaired weight-bearing function. Early diagnosis relies largely on magnetic resonance imaging, while conservative treatment still has limitations, including a relatively long treatment course and insufficient structural protection. Based on the theory in the Huangdi Neijing that “the kidney governs bone and marrow,” and in combination with clinical experience, this paper proposes that the disease is characterized by a pattern of deficiency in origin and excess in superficiality, with deficiency of kidney essence and marrow as the root and collateral stasis with bony impediment as the manifestation. The key site of the lesion is considered to be the subchondral bone–bone marrow region. Treatment should focus on tonifying the kidney, replenishing marrow, and strengthening the sinews and bones, supplemented by promoting blood circulation, unblocking the collaterals, and relieving pain, with flexible modification according to disease stage and syndrome evolution. The presented case suggests that this approach can alleviate pain and improve knee joint function, and may provide a reference for the traditional Chinese medicine treatment of spontaneous osteonecrosis of the knee.

  Key words: spontaneous osteonecrosis of the knee; the kidney governs bone and generates marrow; tonifying the kidney and replenishing marrow; famous physician’s experience

  提交时间：2026-04-10

  版权声明：作者本人独立拥有该论文的版权，预印本系统仅拥有论文的永久保存权利。任何人未经允许不得重复使用。
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• 序号	提交日期	编号	操作
  1	2026-03-13	10.12201/bmr.202604.00074V1	下载

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