基于“筋骨-经脉”理论从肝、脾、肾三脏论治类风湿关节炎  

Treatment of rheumatoid arthritis from three viscera of liver,spleen and kidney based on the theory of“muscles,bones-meridians”

作　　者：宋思淼 王玲[2] SONG Simiao;WANG Ling

机构地区：[1]辽宁中医药大学,辽宁沈阳110847 [2]辽宁中医药大学附属医院,辽宁沈阳110033

出　　处：《中医临床研究》2023年第12期10-14,共5页Clinical Journal Of Chinese Medicine

摘　　要：类风湿关节炎(Rheumatoid Arthritis,RA)是一种全身性自身免疫性疾病,近年来发病率呈逐渐增高的趋势,且致残率高,常常严重影响患者的生活质量,给患者带来痛苦的折磨。该病因病机十分复杂,在临床当中的治疗颇为棘手。常规的西医治疗以非甾体抗炎药、糖皮质激素以及抗风湿药物等来控制病情,但疗效并不显著,因此临床上常常结合中医药治疗以提高疗效。中医临床多认为RA的病因病机与肝、脾、肾三脏密不可分,且该病常累及经脉、筋、骨、关节等部位。文章基于“筋骨-经脉”理论,从肝、脾、肾三脏的角度出发,着重讨论了RA病因病机与肝、脾、肾三脏的关系,肝、脾、肾三脏的脏腑功能失调是其发病之本,肝失疏泄、肝失所养,脾失健运、脾气虚弱,肾精亏虚等均可导致痹证发生。又从“肝脾肾-筋骨”、“肝脾肾-经脉”两个方面深入探讨了RA的辨治,“肝脾肾-筋骨”方面,在中医临床中常常以健脾除湿、补益肝肾为基本治疗原则,以使筋骨得以强健,关节得以流利;“肝脾肾-经脉”方面,从肝经、脾经、肾经的角度出发,调畅肝、脾、肾三经气血,则通而不痛。文章以此理论为核心探究RA论治,并结合医案予以辅证,以期为临床提供相关的理论支持与诊疗思路。Rheumatoid arthritis is a systemic autoimmune disease,the incidence of which has gradually increased in recent years,and its disability rate is high,which often seriously affects the quality of life of patients and brings painful suffering to patients.The etiology and pathogenesis are very complex,and the clinical treatment is quite tricky.Conventional Western medicine treatment uses non-steroidal anti-inflammatory drugs,glucocorticoids and anti-rheumatic drugs to control the disease,but the efficacy is not significant,so clinical treatment is often combined with traditional Chinese medicine to improve the efficacy.Traditional Chinese medicine clinically believes that the etiology of rheumatoid arthritis is inseparable from the liver,spleen and kidneys,and the disease often involves meridians,tendons,bones,joints and other parts.Based on the theory of“muscles,bones-meridians”,the paper focuses on the relationship between the etiology of rheumatoid arthritis and the liver,spleen and kidneys from the perspective of the liver,spleen and kidneys,and the dysfunction of the three organs of the liver,spleen and kidney is the root of its pathogenesis,liver fails in controlling conveyance and dispersion,liver fails in nourishing,dysfunction of the spleen in transport,weakness of spleen Qi(气)and kidney essence deficiency lead to the occurrence of paralysis.In addition,the identification and treatment of rheumatoid arthritis is discussed in depth from the two aspects of“liver,spleen,kidney-muscles and bones”and“liver,spleen,kidneys,and meridians”.In the clinical practice of traditional Chinese medicine,the basic treatment principles of strengthening the spleen and dehumidifying and nourishing the liver and kidneys are often adopted,so that the muscles and bones can be strong and the joints can be fluent.In terms of“liver,spleen,kidneys,and meridians”,from the perspective of liver meridians,spleen meridians,and kidney meridians,regulating Qi and blood of the liver,spleen and kidney meridians will relieve pa

关 键 词：“筋骨-经脉”理论 从肝脾肾论治 类风湿关节炎 

分 类 号：R274[医药卫生—中医骨伤科学]