摘要
类风湿性关节炎(Rheumatoid Arthritis, RA)是以对称性全身多关节肿胀为特征的自身免疫疾病,古籍中对该病有系统的认知,而中医药治疗有确切的疗效。文章探讨类风湿性关节炎与《金匮要略》中湿痹、历节的发病机制与临床表现的相关性,认为湿痹与历节病理基础相类,属于仲景所论的广义“湿病”的不同时期。风寒湿邪侵袭,痹阻气血,病位偏表,正气未衰,则属于湿痹的范畴,而病情发展累及肝肾及筋骨关节,则属于历节范畴,湿痹可以病传至历节。据此总结了《金匮要略》相关的证治方药,为不同时期的类风湿性关节炎提出治疗思路。根据病位的深浅变化,早期可使用麻黄加术汤、麻杏薏甘汤、防己黄芪汤,表里俱虚的桂枝附子汤、白术附子汤、甘草附子汤,而后期可使用桂枝芍药知母汤和乌头汤。
Rheumatoid arthritis(RA)is a systematic auto-immune disorder involving symmetrical and swollen joints.Ancient books have a systematical recognition toward RA.Traditional Chinese medicine has a definite effect on the treatment of RA.This article discussed the correlation in etiology,pathogenesis,and clinical manifestations among RA,dampness impediment,and multiple arthralgia,considering the pathological process of dampness impediment and multiple arthralgia was similar,which belonged to different periods of general“dampness disease”put forward by ZHANG Zhong-jing.Wind,cold,and dampness pathogens attack superficies and then lead to stagnation of qi and blood.When disease locates in the exterior and deficiency of healthy qi is not severe,it is classified as dampness impediment.When the process continues involving liver,kidney,as well as tendon,bone,and joint,it is classified as multiple arthralgia.Dampness impediment can transmit to multiple arthralgia.Based on Essentials from the Golden Cabinet,this article summarized common syndromes,treatments,prescriptions,and herbs,providing some thoughts for treating RA in different stages.At early stage of RA,Mahuangjiazhu Decoction,Maxing Yigan Decoction,and Fangji Huangqi Decoction can be applied.As the disease progresses,Guizhi Fuzi Decoction,Baizhu Fuzi Decoction,and Gancao Fuzi Decoction can be used.At the later period,Guizhi Shaoyao Zhimu Decoction and Wutou Decoction can be used.
作者
詹静怡
陈思婷
林昌松
ZHAN Jing-yi;CHEN Si-ting;Lin Chang-song(The First Clinical College,Guangzhou University of Chinese Medicine,Guangzhou Guangdong 510006;The Second Clinical College,Guangzhou University of Chinese Medicine,Guangzhou Guangdong 510006;The First Affiliated Hospi-tal of Guangzhou University of Traditional Chinese Medicine,Guangzhou Guangdong 510006)
出处
《世界中西医结合杂志》
2023年第3期601-604,614,共5页
World Journal of Integrated Traditional and Western Medicine
关键词
湿痹
历节
金匮要略
类风湿性关节炎
Dampness Impediment
Multiple Arthralgia
Essentials from the Golden Cabinet
Rheumatoid Arthritis
