以痿痹辨治风湿病继发肌少症  

Syndrome Differentiation and Treatment of Secondary Sarcopenia Related to Rheumatic Diseases from the Perspective of Wei Bi(痿痹)

作　　者：白雯 阎小萍[2] BAI Wen;YAN Xiaoping(Beijing Fengtai Hospital of Integrated Traditional and Western Medicine,Beijing,100072;China-Japan Friendship Hospital)

机构地区：[1]北京市丰台中西医结合医院,北京市100072 [2]中日友好医院

出　　处：《中医杂志》2022年第24期2316-2320,共5页Journal of Traditional Chinese Medicine

基　　金：北京中医药“薪火传承3+3工程”(阎小萍名医传承工作站)。

摘　　要：总结从痿痹辨治风湿病继发肌少症的经验。风湿病常继发肌少症,根据其病证特点,认为其发病与“因痹致痿”的过程高度吻合,病因病机以肝脾肾亏虚、筋肉骨髓失养为本,风寒湿邪侵袭为外在致病条件,痰浊瘀血等内生病理产物可进一步加重疾病的发展。临床可以“痿痹”辨治,以补肾填精、固卫和营,健脾益气、养血充肌,补血益精、养肝荣筋,祛邪通络、燮理气机等多种治法协同配伍。此外,提出在痹证的治疗中要重视“欲痿”的辨治,以防止痹证发为痿痹。This paper summarized the experience in syndrome differentiation and treatment of sarcopenia secondary to rheumatic diseases from the perspective of wei bi(痿痹).Patients with rheumatic diseases may often suffer from sarcopenia lately,and its pathogenesis is highly consistent with the process of“wei(痿)caused by bi(痹)”.Liver-spleen-kidney depletion and sinew-flesh-bone marrow losing nourishment are considered to be the root of the disease,while wind,cold and damp invasion is the external pathogenic factor,and internal pathological products such as phlegm turbidity and blood stasis may further aggravate the condition.Clinically,it is recommended to differentiate the syndrome and treat the disease from wei bi,by integrating multiple treatment methods such as supplementing kidney and essence,consolidating wei qi and harmonizing ying level;fortifying the spleen and boosting qi,nourishing blood and engendering flesh;supplementing blood and boosting essence,nourishing the liver and sinew;dispelling pathogen and unblocking collaterals,soothing and rectifying qi movement.Simultaneously,attention should be paid to the differentiation and treatment of“upcoming potential wei”in treating bi diseases,so as to prevent bi diseases from transferring into wei bi.

关 键 词：风湿病 肌少症 痿痹 痹证 痿证 名医经验 阎小萍 

分 类 号：R249[医药卫生—中医临床基础] R259[医药卫生—中医学]