基于脏腑气血辨论探讨金明秀教授治疗郁痹共病经验  

Discussion on Professor JIN Mingxiu’s experience in treating depression with arthralgia based on the theory of viscera Qi and blood

作　　者：张名秀 于静[2] 金明秀[2] ZHANG Mingxiu

机构地区：[1]辽宁中医药大学,辽宁沈阳110000 [2]辽宁中医药大学附属医院,辽宁沈阳110000

出　　处：《中医临床研究》2024年第16期121-126,共6页Clinical Journal Of Chinese Medicine

基　　金：益气养阴通络方调控PTEN/PI3K/AKT信号通路抑制RA滑膜成纤维细胞焦亡的分子机制研究(2022JH2/101300089)。

摘　　要：类风湿关节炎属于中医学“痹证”范畴,是由于邪气痹阻经络导致人体关节僵硬、肿胀、疼痛甚至变形等症状的一类疾病。痹证具有病情缠绵、复杂难愈的特点,并且其发病过程往往与患者的心理状态有密切关系。精神情志类疾病多属于中医“郁证”范畴。临床发现大部分痹证患者存在抑郁、焦虑等情志异常状态,“因痹致郁”或“因郁致痹”导致“郁痹共病”的状况屡见不鲜。金明秀教授在临床实践中发现,很多“郁痹共病”的患者存在脏腑气血功能失调,进而出现脏腑气血同病的现象。金明秀教授指出“郁痹共病”病机丛杂,虚实互现,多脏受累。基于脏腑气血辨论,金教授认为本病的病机为脏腑亏虚,痰、瘀、郁互结,气机阻滞,气血痹阻经脉;其病理性质为本虚标实,以脾肾亏虚为本,肝气郁结、痰瘀阻络为标。治疗应从脏腑气血的角度出发:以化痰祛瘀,解郁通络为核心;立足于整体观,重视调理气机、调整脏腑功能;治疗上均着眼于肝、脾、肾三脏之间功能相互协调平衡;注重从整体出发,关注五脏之平衡关系、气血的生成与运行,以及情志自我调节等方面进行综合考虑;强调调畅气机、调整脏腑功能在治疗过程中所起的作用及意义。文章基于中医基础理论,从脏腑气血入手,对“郁痹共病”的病因病机进行深入分析,并结合金教授治疗经验探讨其在临床治疗中的应用,以期为临床提供一定参考。Rheumatoid arthritis belongs to the category of Bi syndrome(痹证)in traditional Chinese medicine,which is a kind of disease with the main clinical manifestations of joint stiffness,swelling,pain and even deformation due to the obstruction of channels and meridians by pathogenic factors.Bi syndrome has the characteristics of lingering,complex and difficult to heal,and its pathogenesis is often closely related to the psychological state of patients.Mental and emotional diseases mostly belong to the scope of Yu(郁)syndrome in traditional Chinese medicine.Clinically,it is found that most patients with Bi syndrome have emotional abnormalities such as depression and anxiety,and it is common that depression due to paralysis or paralysis caused by depression leads to depression with arthralgia.Professor JIN Mingxiu has found in clinical practice that many patients with depression and arthralgia have dysfunction of viscera Qi(气)and blood,and then appear the phenomenon of viscera Qi and blood comorbidity.Professor JIN Mingxiu points out that the pathogenesis of depression with arthralgia is complicated,with both deficiency and excess occurring,and many viscera are involved.Based on the theory of viscera Qi and blood,Professor JIN believes that the pathogenesis of this disease is visceral deficiency,mutual accumulation of phlegm,stasis and depression,Qi movement blockage,leading to Qi and blood blocking the meridians.Its pathological properties are based on deficient root and excessive superficial,with both spleen and kidney deficiency as the basis,and liver Qi stagnation,and phlegm and stasis blocked collaterals as the superficial syndrome.The treatment should be start from the perspective of viscera Qi and blood,with removing phlegm and blood stasis,and relieving depression and dredging collaterals as the core,based on the overall view,attention should be paid to regulating Qi movement and adjusting the function of viscera.Specifically,the treatment focuses on the coordination and balance of the functions of the live

关 键 词：痹证 类风湿关节炎 郁证 抑郁症 治疗经验 

分 类 号：R256[医药卫生—中医内科学]