从“湿”辨治高尿酸血症及其并发症理论探析  

Exploration on the Differentiation and Treatment of Hyperuricemia and Its Complications from the Perspective of Pathogenic Damp

作　　者：陈静[1] 徐鹏 黎创[2,3] 曾艳秋 毛炜[2,3,4] 胡天祥 CHEN Jing;XU Peng;LI Chuang;ZENG Yan-Qiu;MAO Wei;HU Tian-Xiang(The Second Clinical Medical School of Guangzhou University of Chinese Medicine,Guangzhou 510006 Guangdong,China;State Key Laboratory of TCM Dampness Syndrome(The Second Affiliated Hospital of Guangzhou University of Chinese Medicine),Guangzhou 510120 Guangdong,China;Dept.of Nephrology,Guangdong Provincial Hospital of Traditional Chinese Medicine,Guangzhou 510120 Guangdong,China;Nephropathy Laboratory,Guangdong Provincial Hospital of Traditional Chinese Medicine,Guangzhou 510120 Guangdong,China;Chinese Medicine Thinking Research Office,Guangdong Provincial Hospital of Traditional Chinese Medicine,Guangzhou 510120 Guangdong,China)

机构地区：[1]广州中医药大学第二临床医学院,广东广州510006 [2]省部共建中医湿证国家重点实验室(广州中医药大学第二附属医院),广东广州510120 [3]广东省中医院肾病科,广东广州510120 [4]广东省中医院肾病研究室,广东广州510120 [5]广东省中医院中医思维研究室,广东广州510120

出　　处：《广州中医药大学学报》2023年第7期1810-1815,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(编号:82074376);广东省中医药局科研项目(编号:20201140);省部共建中医湿证国家重点实验室课题(编号:SZ2020ZZ04,SZ2021ZZ50,SZ2021ZZ1001)。

摘　　要：分析高尿酸血症及其并发症的中西医演变规律,认为“湿邪为患”在该病的发展过程中具有关键作用,且具有湿在血脉、湿侵关节、湿入脏腑等的传变规律;湿邪易与他邪相兼为患,可表现为湿浊、风湿、湿热、痰湿、湿瘀等。在“既病防变”治疗原则的指导下,结合分析高尿酸血症患者的临床表现,提出治疗高尿酸血症当分以下阶段:若湿在血脉,当健脾利水渗湿;若湿侵关节,可祛风除湿、清热利湿、化痰活血;若湿入脏腑,当清热利湿通淋、补肾活血利水。This study analyzed the evolution of hyperuricemia and its complications in the field of traditional Chinese medicine and western medicine,and it is concluded that pathogenic damp plays a key role in the development of the disease,and exerts the transmission pattern of accumulating in the blood vessels firstly,attacking the joints secondly and attacking the zang-fu organs finally.The attack of pathogenic damp occurs usually together with other pathogens and then the syndromes of damp-turbidity,wind-damp,damp-heat,phlegmdamp,and damp-stasis are manifested.Under the guidance of the therapeutic principle of“prevention of aggravation after disease”and in conjunction with the analysis of clinical manifestations of the hyperuricemia patients,we proposed that the treatment of hyperuricemia can be performed as the following:for the patients with pathogenic damp accumulating in the blood vessels,therapies of invigorating spleen,inducing diuresis and draining dampness are recommended;for the patients with pathogenic damp attacking the joints,therapies of dispelling wind and removing dampness,clearing heat and draining dampness,and resolving phlegm and activating blood can be adopted;for the patients with pathogenic damp attacking the zang-fu organs,therapies of clearing heat,draining dampness and relieving stranguria,and tonifying kidney,activating blood and inducing diuresis can be used.

关 键 词：高尿酸血症 湿邪 并发症 健脾利水渗湿 祛风除湿 清热利湿 补肾活血利水 

分 类 号：R589.2[医药卫生—内分泌]