论类风湿性关节炎痹痿同存同治  

Discussion of Coexistence and Treatment of Arthralgia and Flaccidity in Rheumatoid Arthritis

作　　者：张杨[1] 刘妍彤 张杰[1] ZHANG Yang;LIU Yangtong;ZHANG Jie(The First Hospital of China Medical University,Shengyang 110001,China)

机构地区：[1]中国医科大学附属第一医院,沈阳110001

出　　处：《中国中医基础医学杂志》2023年第5期731-733,共3页JOURNAL OF BASIC CHINESE MEDICINE

基　　金：国家自然科学基金项目(81973661);辽宁省中医药管理局(辽卫函[2016]78号);辽宁省中医药临床学(专)科能力建设项目(辽中医药函字[2018]27号)。

摘　　要：在中医学理论体系中,痹、痿两种疾病在病因病机、辨证论治方面均不相同,但痹病可以导致痿病的发生。类风湿关节炎主要影响肢体关节,亦可影响筋脉肌肉,从而形成痹痿并存的症状。“脾虚”在痹与痿的发病、发展以及演变中具有重要作用。脾虚为本,营卫失和,外湿引动内湿,湿邪困脾,加重脾虚,影响五脏,故外及肢体,内及脏腑。病情进一步发展,脾虚失养,或脾虚湿阻,因痹致痿,故出现肉痿筋弛,肺痿咳喘。据此提出:健脾化湿,以调营卫、滋气血、利关节、濡肌肉、强筋骨,同时兼顾补脾养五脏,通五脏痹,养五脏痿。故从脾论治类风湿关节炎,可以涵盖类风湿关节炎各个病理阶段,实现痹与痿同治。In the theoretical system of traditional Chinese medicine,the etiology,pathogenesis and treatment of arthralgia and Flaccidity are different,but arthralgia disease can lead to the occurrence of Flaccidity disease.Rheumatoid arthritis mainly affects the limb joints,but also affects the muscles,thus forming the symptoms of arthralgia Flaccidity co-existence."Spleen Deficiency"plays an important role in the pathogenesis,development and evolution of arthralgia and Flaccidity.Due to spleen deficiency,Ying Flaccidity disharmony,external dampness leads to internal dampness,dampness evil traps spleen,aggravates spleen deficiency and affects five Zang organs.The further development of the disease,Spleen deficiency aggravation,dampness trapped spleen,lead to Flaccidity caused by arthralgia,it appears muscle atrophy,lung flaccidity,cough and asthma.It is suggested that invigorating the spleen and removing dampness,regulating Ying and Flaccidity,nourishing Qi and blood,benefiting joints,moistening muscles,strengthening muscles and bones,and at the same time,tonifying the spleen and nourishing the five Zang organs,dredging the obstruction of the five Zang organs,and nourishing the five Zang organs.Therefore,the treatment of rheumatoid arthritis from the spleen can cover all pathological stages of rheumatoid arthritis,and achieve the same treatment of arthralgia and Flaccidity.

关 键 词：脾虚 类风湿关节炎 痹 痿 

分 类 号：R255.6[医药卫生—中医内科学]