历节病并发奔豚病的病机及证治探讨  

Discussion on Pathogenesis Syndrome and Treatment of Lijie Disease Combined with Bentun Disease

作　　者：邝浩丹 黄琳[1] 肖硕实 温成平[1] KUANG Haodan;HUANG Lin;XIAOShuoshi(Zhejiang Chinese Medical University,Hangzhou(310053),China;Hangzhou Xiacheng District Hospital of Traditional Chinese)

机构地区：[1]浙江中医药大学,杭州310053 [2]杭州市下城区中医院

出　　处：《浙江中医药大学学报》2021年第7期713-717,共5页Journal of Zhejiang Chinese Medical University

基　　金：国家重点研发计划项目(2018YFC1705500)。

摘　　要：[目的]探讨历节病并发奔豚病的核心病机及证治方法。[方法]通过查阅并梳理《黄帝内经》《金匮要略》《针灸甲乙经》等经典文献中与历节病、奔豚病密切相关的文献资料,从文献中整理总结历节病和奔豚病的病因,并分析各个证候类型的核心病机,找出相应的辨证论治方法。[结果]文献表明,误汗、误水、误下、劳后当风、饥饿、烧针后感寒是历节病并发奔豚病的常见诱因。从疾病的发展来看,历节病并发奔豚病起于太阳气衰,风寒湿邪袭表;进展于寒气闭郁,肺气不宣;加剧于痹热血虚。疾病慢性迁延难愈的主要病机是脾阳不振、肝肾虚损,水寒积结。主要证候治法可以概括为以下几方面:风湿袭表、玄府不通,治法为祛风除湿、调和营卫;寒湿闭郁、肺气不宣,治法为宣肺散寒、利湿逐痹、祛邪畅气;痹热血虚、肝郁气逆,治法为清热养血、平冲逐痹;脾虚失运、湿邪阻络,治法为健脾运湿、温阳通络;肝肾虚损、水寒积结,治法为补益肝肾、养复血气、通阳泄浊、平降冲气。[结论]历节病并发奔豚病作为一种复杂疾病,以风寒湿外感为起因,以脾虚失运、痰湿瘀阻脉络为核心病机,以健脾运湿、理气通络为核心治疗方法。辨证论治时需要重视热痹血虚、水寒积结下焦等问题。[Objective]To explore the common etiology,pathogenesis and treatments of Lijie disease combined with Bentun disease.[Methods]Through consulting and combing the classic literature such as“Inner Canon of the Yellow Emperor”“Synopsis of Prescriptions of the Golden Chamber”and“Classic of Acupuncture and Moxibustion”,which are highly related to Lijie disease and Bentun disease,the etiology of Lijie disease and Bentun disease was sorted out from the literature,and the core pathogenesis of each stage was summarized to find out the treatment method of Lijie disease combined with Bentun disease.[Results]The literature showed that the common inducements of Lijie disease combined with Bentun disease were inappropriate sweating,misuse of water,misuse of the reduction,catching a chill after tiredness,hunger,cold after burning needle.According to the development process of Lijie disease combined with Bentun disease,the disease starts from the decline of Taiyang Qi,wind cold and dampness attacking the exterior,progresses in the stagnation of cold Qi,the stagnation of lung Qi,and aggravates the deficiency of heat arthralgia and blood.Inactivation of spleen Yang,deficiency of the liver and kidney,water and cold accumulation are the main pathogenesis of chronic persistent disease.The treatment and syndrome of this disease can be summarized as follows aspects:For wind and dampness attacking the exterior,sweat pore is impassable,the treatment should be expelling wind and removing dampness,and harmonizing Ying and Wei;for cold and dampness stagnation,lung Qi can't be released,the treatment should be dispersing cold and diffusing the lung,removing dampness and arthralgia,dispelling pathogenic factors and invigorating Qi;for arthralgia heat and blood deficiency,liver stagnation and Qi inversion,the treatment is clearing heat and nourishing blood,descending thrusting and removing arthralgia;for spleen deficiency and dampness obstructing collaterals,the treatment should be invigorating the spleen and removing dampness,warming

关 键 词：历节病 奔豚病 核心病机 风水病 黄汗 痹证 类风湿性关节炎 中医文献 

分 类 号：R684[医药卫生—骨科学]