朱章志基于六经辨证治疗高尿酸血症的思路探析  

Exploration of ZHU Zhang-Zhi's Thoughts for the Treatment of Hyperuricemia Based on Six-Meridian Syndrome Differentiation

作　　者：黄帅立 朱章志(指导)[2] HUANG Shuai-Li;ZHU Zhang-Zhi(Guangzhou Integrated Chinese and Western Medicine Hospital Affiliated to Guangzhou University of Chinese Medicine,Guangzhou 510800 Guangdong,China;The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China)

机构地区：[1]广州中医药大学附属广州中西医结合医院,广东广州510800 [2]广州中医药大学第一附属医院,广东广州510405

出　　处：《广州中医药大学学报》2024年第7期1886-1889,共4页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(编号:82174284)。

摘　　要：高尿酸血症为嘌呤代谢障碍所致的慢性代谢性疾病。无症状的高尿酸血症可归属于中医学的“血浊”范畴;高尿酸血症出现关节炎、痛风、高血压等表现后,可归属于中医“痹证”等范畴,现代中医多从“痰湿”和“湿热”辨治。朱章志教授认为,高尿酸血症的病机辨识当首辨阴阳,以阳虚为本,再辨六经,以“三阴”为要,即关注太阴中焦脾胃升降之气机、太阴肺表之邪侵、少阴肾阳之虚衰;高尿酸血症的治疗需立足扶助人体阳气,重视顾护脾胃,不忘祛邪,寒热同调,即注重温助太阴脾阳以复脾胃升降之气机,宣散太阴肺表以祛邪,中后期患者宜温肾阳以利湿,遣方用药特点为寒热同调。朱章志教授基于六经辨证采用经方并重在扶阳以治疗高尿酸血症之思路,可为中医药临床工作者辨治高尿酸血症提供借鉴。Hyperuricemia is a chronic metabolic disease caused by purine metabolic disorder.Asymptomatic hyperuricemia can be attributed to the category of turbid blood in the field of traditional Chinese medicine(TCM).When hyperuricemia appears arthritis,gout and hypertension,it can be attributed to the category of bi-syndrome in TCM.Modern TCM practitioners usually treat hyperuricemia from the perspective of phlegm-dampness and damp-heat.ZHU Zhang-Zhi believes that for the treatment of the hyperuricemia,the identification of the pathogenesis being yin or yang should be made firstly,and yang deficiency is the fundamental pathogenesis of hyperuricemia.Secondly,six-meridian syndrome differentiation can be carried out,and the three yin-syndromes are the key types to be stressed,that is,more attention should be paid to the ascending and descending qi movement of spleen and stomach in taiyin middle energizer,the pathogenic invasion of the exterior of taiyin lung,and the deficiency of shaoyin kidney yang.The treatment of hyperuricemia should be based on supporting yang qi of the human body,and the protection of spleen and stomach should be stressed besides the elimination of pathogenic factors and the simultaneous regulation of cold and heat.Therapy of warming and assisting the spleen yang of taiyin is helpful for restoring the ascending and descending qi movement of the spleen and stomach,and dispersing the exterior of taiyin lung is beneficial to eliminate pathogenic factors.In the middle and late stages of hyperuricemia,therapy of warming the kidney yang to remove dampness is recommended,and the prescription is characterized by the simultaneous regulation of cold and heat.Professor ZHU Zhang-Zhi's thoughts for treating hyperuricemia based on syndrome differentiation of six meridians and by using classical formulas stressed on supporting yang can provide reference for clinical TCM practitioners in treating hyperuricemia.

关 键 词：高尿酸血症 六经辨证 辨阴阳 阳虚 扶阳 寒热同调 朱章志 

分 类 号：R259.897[医药卫生—中西医结合]