摘要
缓和性血清阴性对称性滑膜炎伴凹陷性水肿(remitting seronegative symmetrical synovitis with pitting edema,RS3PE)综合征的病因病机主要为正虚感邪、痹阻关节,肺脾肾虚、水液代谢失常。对于本病证型的认识,临床医家各有特点,辨证分型归纳为湿热蕴结,脾肾亏虚型。治疗方面,中药或针灸联合西药治疗本病不仅能够提高疗效,亦能在疾病缓解期使西药稳固撤减,降低不良反应。此外,需注重预后与调护以益于疾病的治疗。目前,中医药治疗RS3PE综合征仍存在许多不足之处,如现有文献多基于临床病例报道,证据强度较低;本病缺乏统一、明确、规范化的诊断、辨证及治疗;对中药、针灸治疗本病的机制研究较少。为此,应当总结中医药治疗RS3PE综合征的经验,积极开展多中心、大样本的循证医学研究,形成统一的具有中医药特色的诊疗规范,同时,加强基础研究以揭示中医药治疗本病的作用机制,从而全面提高中医药治疗的科学性。
The etiology and pathogenesis of remitting seronegative symmetrical synovitis with pitting edema(RS3PE)syndrome mainly include positive deficiency,paralysis and obstruction of joints,deficiency of lungs,spleen and kidney,and abnormal water metabolism.For the understanding of the syndrome types of this disease,clinicians have their own characteristics,and the main types of syndrome differentiation are damp-heat accumulation and spleen and kidney deficiency.In terms of treatment,the combination of Chinese medicine or acupuncture and Western medicine in the treatment of this disease can not only improve the efficacy,but also make the Western medicine steadily withdrawn during the remission period of the disease and reduce adverse reactions.In addition,it is necessary to pay attention to prognosis and care for the treatment of the disease.At present,there are still many shortcomings in the treatment of RS3PE syndrome with traditional Chinese medicine,such as the existing literature is mostly based on clinical case reports,and the strength of the evidence is low;There is a lack of unified,clear and standardized diagnosis,syndrome differentiation and treatment of this disease;There are few studies on the mechanism of traditional Chinese medicine and acupuncture in the treatment of this disease.Therefore,it is necessary to summarize the experience of traditional Chinese medicine in the treatment of RS3PE syndrome,actively carry out multi-center and large-sample evidence-based medical research,form a unified diagnosis and treatment standard with traditional Chinese medicine characteristics,and strengthen basic research to reveal the mechanism of action of traditional Chinese medicine in the treatment of this disease,so as to comprehensively improve the scientific nature of traditional Chinese medicine treatment.
作者
马玉草
吕柳
胡杰
黄正慧
王海隆
MA Yucao;LYU Liu;HU Jie;HUANG Zhenghui;WANG Hailong(Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine,Beijing China 100700)
出处
《中医学报》
CAS
2024年第3期542-546,共5页
Acta Chinese Medicine
基金
国家自然科学基金面上项目(82174336)
国家自然科学基金青年项目(82104652)
全国中医临床优秀人才项目[国中医药人教函(2022)1号]
首都卫生发展科研专项项目(CFH 2022-2-7087)。
关键词
缓和性血清阴性对称性滑膜炎伴凹陷性水肿综合征
病因病机
辨证分型
remitting seronegative symmetrical synovitis with pitting edema syndrome
etiology and pathogenesis
syndrome differentiation
