金实教授以益肾通络法论治类风湿性关节炎继发骨质疏松症  

Professor Jin Shi's Experience in Treating Rheumatoid Arthritis with A Secondary Osteoporosis by Benefiting the Kidney and Unblocking the Collaterals

作　　者：杨帆[1] 曹晶[1] YANG Fan;CAO Jing(The Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,China)

机构地区：[1]南京中医药大学附属医院,江苏南京210029

出　　处：《南京中医药大学学报》2022年第12期1160-1163,共4页Journal of Nanjing University of Traditional Chinese Medicine

基　　金：第七批全国老中医药专家学术经验继承工作项目(国中医药人教函〔2022〕76号);江苏省第十五批“六大人才高峰”高层次人才资助项目(WSW-012);国家自然科学基金面上项目(81804070);江苏省自然科学基金(BK20191415)。

摘　　要：类风湿性关节炎是临床常见的慢性全身免疫性疾病,金实教授认为该病始于先天肾精亏虚,长期病程中因气血化生乏源,运行不畅,滋生凝痰败瘀,药物使用及肢体残疾亦会加重这一本虚标实之证。骨络是运行气血的细微结构,常因气血虚弱而发生虚损,亦易为凝痰败瘀所痹阻;骨络功能缺失,骨髓失以濡养,以致骨枯髓减,从而继发骨质疏松症。金实教授以肾精亏虚、骨络痹阻为类风湿性关节炎继发骨质疏松症的核心病机,采用益肾通络的治则治法进行遣方用药,取得了较好的临床疗效。Rheumatoid arthritis is a common chronic systemic immune disease.Professor Jin Shi believes that the disease begins with congenital deficiency of kidney essence.After the long course of the disease,the lack of production and transformation source of qi and blood can lead to the poor qi movement and blood circulation.As the condition gets worse,it will breed pathogenic phlegm and stasis.Besides,excessive drug use and physical disability can also exacerbate the disease,which is deficiency in root and excess in manifestation.Bones and collaterals are the delicate structures for running qi and blood,which are often weakened by qi-and blood-deficiency.In addition,they are easily paralyzed by pathogenic phlegm and stasis.The disfunction of bones and collaterals can lead to bone marrow malnutrition,further resulting in bone withering and marrow reduction,and thus leading to osteoporosis.Professor Jin Shi took the deficiency of kidney essence,combined with paralysis and obstruction of bone and collaterals as the core pathogenesis of rheumatoid arthritis with a secondary osteoporosis.Therefore,when the treatment method of benefiting kidney and unblocking the collaterals is applied clinically,a better therapeutic effect can be achieved.

关 键 词：类风湿性关节炎 骨质疏松症 肾虚络阻 益肾通络汤 

分 类 号：R249[医药卫生—中医临床基础]