孟庆良基于浊瘀理论治疗痛风性关节炎  

Meng Qingliang′s Treatment Gouty Arthritis Based on Turbid and Stasis Theory

作　　者：宋晨阳 孟庆良[2] SONG Chenyang;MENG Qingliang(College of Bone Injury,Henan University of Chinese Medicine,Zhengzhou Henan China 450046;The Second Affiliated Hospital to Henan University of Chinese Medicine/Henan Province Hospital of Chinese Medicine,Zhengzhou Henan China 450002)

机构地区：[1]河南中医药大学骨伤学院,河南郑州450046 [2]河南中医药大学第二附属医院/河南省中医院,河南郑州450002

出　　处：《中医学报》2024年第7期1497-1502,共6页Acta Chinese Medicine

基　　金：国家自然科学基金委员会面上项目(8187151500);河南省中医药科学研究专项课题项目(2019ZY2032,20-21ZYZD05)。

摘　　要：痛风的病因为外感风寒,内蕴痰湿,病理基础为痰浊和瘀血,为本虚标实之证,以浊瘀痹阻为标,脾肾不足为本。临证从“浊瘀”立论,以泻浊化瘀为总法,将调益脾肾、培补正气贯穿治疗始终,注重内外配合增强疗效,辨证运用清热祛湿,补脾益肾等治法,方选自拟痛风汤。痛风急性期以标实为主,因湿热搏结于关节而致局部红肿、发热伴剧烈疼痛,故在治疗上主要选取泻化湿浊药物,配合活血行气之品,促进湿浊泻化,缓解疼痛;痛风缓解期虽少有疼痛症状,但由于瘀血阻络,湿浊瘀互结,深居筋骨关节,局部则出现肿胀畸形,因此治疗宜以扶正为主,兼化瘀之法,通过补益人体正气,推陈致新,促进瘀结之溶解。The disease of gout is due to external Wind Cold and internal Phlegm Dampness.The pathological basis is Phlegm Turbid and blood stasis,which is the syndrome of the deficiency in root and the excess in symptoms.The excess in symptoms means the obstruction of Turbid and stasis,while the deficiency in root means the deficiency of the Spleen and Kidney.In clinical practice,based on the thought of"Turbidity and stasis factor",purging turbidity and dissolving stasis is considered as the general principle,and regulating the Spleen and Kidney,supplementing the Zheng Qi should be carried out throughout the treatment,paying attention to internal and external cooperation to enhance the curative effect.With the dialectical use of Heat clearing and Dampness as well as tonifying Spleen and Kidney and other treatment methods,the newly created Tongfeng Decoction is applied.The acute phase of gout is mainly characterized by excess in symptoms,symptoms such as local redness,swelling,fever and severe pain in the joints can be found due to Dampness-Heat stagnation.Therefore,in treatment of gout,the drugs for purging Dampness and Turbidity can be used,being combined with drugs for activating blood and Qi,to promote Dampness-Turbidity purging and relieve pain.Although there are few pain symptoms in the relief period of gout,due to blood stasis blocking the arteries,with Dampness,Turbid and stasis staying deeply in the muscles,bones and joints,local swelling deformity,so the treatment should be strengthening Zheng Qi and removing blood stasis.By tonifying the body′s Zheng Qi,the blood stasis can be dissolved.

关 键 词：痛风性关节炎 浊瘀痹阻 清热祛湿 正本清源 孟庆良 

分 类 号：R249.27[医药卫生—中医临床基础]