中医治疗内因性类风湿关节炎进展  

Progress in Treatment of Endogenic Rheumatoid Arthritis from Perspective of Traditional Chinese Medicine

作　　者：胡建国[1] 万巧巧 HU Jianguo;WAN Qiaoqiao(Sanlian College of Anhui Province,Hefei Anhui China 230601)

机构地区：[1]安徽三联学院

出　　处：《中医学报》2019年第12期2558-2562,共5页Acta Chinese Medicine

基　　金：安徽省高校优秀青年人才支持计划项目(gxyq2018127);国家大学生创业实践项目(201710959054);安徽省教育厅自然科学基金项目(kj2012B066)

摘　　要：类风湿关节炎属于中医"痹证"范畴,其病因有内外两个方面,外因为风、寒、湿热等邪气,内因为五脏六腑失和。正虚不固,邪气乘虚而入,血脉筋骨痹阻而致病。郁证与类风湿关节炎相互影响,肾精亏虚、肝脾不和亦可诱发类风湿关节炎。类风湿关节炎的治疗应从整体出发,多脏器同调,辨证用药,如有郁证应疏肝理气,调畅情志,同时注意肝、脾、肾需同调,治则补脾益气,滋养肝气,健脾运湿,扶正气,补肾活血,疗效显著。目前中医内因治疗类风湿关节炎存在以下问题:各家学说不一,不同医家诊治的理论基础不同,有从郁证理论治疗的,从肾精亏损理论治疗的,从肝脾不和的理论治疗的,各诊疗方法均具有其局限性;类风湿关节炎的临床诊断和治疗指南主要参考西方医学,中医尚未形成统一的诊断和治疗方案。今后对于该病的治疗应以中医辨证思想为中心,以脏腑为基础分型而治,结合现代医学诊疗方案,建立起符合我国国情的类风湿关节炎诊断与治疗标准。Rheumatoid arthritis belongs to the category of"Bi Syndrome"in traditional Chinese medicine.Its causes are both internal and external,and the former causes are Wind,Cold and Damp and Heat Evils and the internal causes are the disharmony between Zang and Fu.When the Zheng Qi is not sufficient,the Evil factors would take advantage of it and the disease would be caused when Blood and Bone activities are negatively influenced.There is a close relationship between stagnation Syndrome and rheumatoid arthritis,and Kidney deficiency,Liver and Spleen disharmony can also induce rheumatoid arthritis.The treatment of rheumatoid arthritis should be based on the whole diagnose and syndrome differentiation,and multiple organs should be co-ordinated.If there is depression Syndrome,methods of soothing the Liver Qi and adjusting the emotions should be used.At the same time,pay attention to the whole regulating of Liver,Spleen and Kidney,and the treating policy should be tonifying Spleen Qi,nourishing Liver Qi,tonifying Spleen and dispelling Dampness to improve Zheng Qi,as well as tonifying Kidney and promoting blood circulation.Thus,the curative effect must be remarkable.At present,there are the following problems in the treatment of rheumatoid arthritis in Chinese medicine:with different theories,the theoretical basis of different doctors’treatment is different.There are treatments from the theory of stagnation syndrome,the theory of kidney deficiency loss treatment,and the theory of Liver and Spleen disharmony.Each diagnosis and treatment method has its limitations;and the clinical diagnosis and treatment guidelines for rheumatoid arthritis mainly refer to Western medicine,while Chinese medicine has not yet formed a unified diagnosis and treatmentplan.In the future,the treatment of this disease should be based on the syndrome differentiation of TCM,based on the diagnosis of Zang and Fu.By combining with modern medical diagnosis and treatment programs,a diagnostic and treatment standard for rheumatoid arthritis in line with Chi

关 键 词：类风湿关节炎 痹证 郁证 肾精亏虚 肝脾不和 

分 类 号：R259[医药卫生—中西医结合]