类风湿关节炎从络论治  

Diagnosis and Treatment of Rheumatoid Arthritis with Collateral Disease Theory

作　　者：蔡晓路[1] 谢晴宇[2] 孟庆刚[1] 

机构地区：[1]北京中医药大学,北京100029 [2]中国中医科学院中医临床基础医学研究所,北京100070

出　　处：《中华中医药学刊》2016年第8期1833-1835,共3页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81273876);北京中医药大学研究生自主项目(2015-JYB-XS010)

摘　　要：从络病角度认识类风湿关节炎(rheumatoid arthritis,RA),认为正虚为本,邪实(痰浊、瘀血)流注络脉,导致络脉不通为其病机;病程迁延、久病久痛、病久内舍于脏的临床表现,符合络病久病入络、久痛入络的发展规律。结合络病三维空间结构,辨RA表里轻重缓急;结合络病在治法上以通为用,RA治疗上应急性期活血化瘀,缓解期通补兼施;RA用药以辛味通络药和虫类通络药为主,并根据寒热虚实斟酌加减,以期为RA临床论治规范化提供新的参考,也为临床其他属络病范畴的疾病诊治提供参考。From the perspective of Collateral Disease Theory,the pathogenesis of rheumatoid arthritis（ RA） can be viewed as the deficiency in nature with pathogen excess（ turbid phlegm,static blood） lingering on collaterals leading to collaterals obstruction. The clinical manifestations of RA such like course deferment,chronic diseases with pain and Zang-organs involvement are in line with the law of development that chronic diseases as well as long-term pain can result in collaterals diseases. This paper discriminated RA exterior and interior syndromes as well as priorities combined with the three-dimensional space structure and discussed that the treatment of RA should promote blood circulation to remove blood stasis in emergency period and dredge and tonify in remission based on collateral disease principle of clearing up obstruction first. Besides,this paper believes that the medication of RA should mainly contain the pungent activating collateral drugs and activating collateral insect drugs,and be adjusted according to cold-heat and deficiency-excess situations. The research is looking forward to provide a new reference for RA clinical differentiation standardized as well as for diagnosis and treatment of other diseases belonged to collateral disease.

关 键 词：类风湿关节炎 络病学说 久病入络 

分 类 号：R241[医药卫生—中医诊断学]