王济华运用角药治疗类风湿关节炎经验  

Wang Jihua′s Experience of Treating Rheumatoid Arthritis with Horn Drugs

作　　者：王荷珺 王子华 杜明瑞 WANG Hejun;WANG Zihua;DU Mingrui(The First Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou,Henan,China,450001)

机构地区：[1]河南省中医药大学第一附属医院,河南郑州450001

出　　处：《河南中医》2024年第3期351-355,共5页Henan Traditional Chinese Medicine

基　　金：河南省拔尖人才培养项目(CZ0262-15);河南省中医药科学研究专项课题项目(2019JDZX2102,2021JDZX2096,2022JDZX047);河南省卫生健康委员会国家中医临床研究基地科研专项项目(2021JDZX2017);河南省第二批中医药青苗人才培养项目(豫卫中医函[2021]16号)。

摘　　要：王济华教授认为,类风湿关节炎早期多因外感风、寒、湿三邪,三者之间相互促进、互相转化,风寒表邪入里日久或郁而化热;病程日久多虚实夹杂,肝肾亏虚、气血不足,同时兼有寒湿痹阻、痰瘀互结。故王教授治疗痹证早期以祛邪散寒为主,兼顾清热利湿、化痰散结,中晚期则偏于滋养气血、补益肝肾。王济华教授运用角药治疗痹证颇有心得,组方精妙、配伍严谨,常用角药川芎-延胡索-白芍行气活血、柔筋止痛;忍冬藤-络石藤-青风藤清热通络、祛风除湿;半夏-陈皮-竹茹燥湿化痰、理气和中;白术-薏苡仁-茯苓益气健脾、利湿消肿;桑寄生-续断-杜仲滋补肝肾、强筋壮骨;酸枣仁-合欢皮-首乌藤宁心安神、解郁除烦。王教授临证时,追求阴阳调和平衡、气机升降有度,临床用药有药简力专、增效减负之功。Professor Wang Jihua believes that in the early stage of RA,it is often caused by the three pathogenic factors of wind,cold,and dampness,and the external pathogenic factors of wind and cold enter the interior for a long time or become depressed,leading to heat transformation.If the course of the disease is long and often mixed with deficiency and excess,liver and kidney deficiency,insufficient qi and blood,as well as cold dampness obstruction and phlegm stasis will occur.Therefore,Professor Wang believes that in the early stage of RA,the treatment should focus on dispelling pathogens and dispersing cold,as well as clearing heat and draining dampness,resolving phlegm and dispersing stasis.In the middle and late stages,the treatment should focus on nourishing qi and blood,and tonifying the liver and kidney.Professor Wang Jihua has a lot of experience of treating RA with horn drugs.The formula formation is exquisite and the compatibility is rigorous.The commonly used horn drugs are as follows:Chuanxiong(Rhizoma Chuanxiong)-Yanhusuo(Rhizoma Corydalis)-Baishao(Radix Paeoniae Alba) can activate qi and blood circulation,soften tendons and relieve pain.Rendongteng(Caulis Lonicerae Japonicae)-Luoshiteng(Caulis Trachelospermi)-Qingfengteng(Caulis Sinomenii) can clean heat and dredge collaterals,removing wind and eliminating dampness.Banxia(Rhizoma Pinelliae)-Chenpi(Pericarpium Citri Reticulatae)-Zhuru(Caulis Bambusae in Taenia) can dry dampness and resolve phlegm,regulate qi and harmonize the middle energizer.Baizhu(Rhizoma Atractylodis Macrocephalae)-Yiyiren(Semen Coicis)-Fuling(Poria) can nourish qi,activate the spleen,drain dampness and reduce swelling.Sangjisheng(Herba Taxilli)-Xuduan(Radix Dipsaci)-Duzhong(Cortex Eucommiae) can nourish the liver and kidney,strengthen tendons and bones.Suanzaoren(Semen Ziziphi Spinosae)-Hehuanpi(Cortex Albiziae)-Shouwuteng(Caulis Polygoni Multiflori) can calm the mind,relieve depression and annoyance.In clinical practice,Professor Wang pursues the balance of yin and yang,as well as the

关 键 词：类风湿关节炎 角药 川芎-延胡索-白芍 忍冬藤-络石藤-青风藤 半夏-陈皮-竹茹 白术-薏苡仁-茯苓 桑寄生-续断-杜仲 酸枣仁-合欢皮-首乌藤 王济华 

分 类 号：R246.2[医药卫生—针灸推拿学]