基于“玄府-气液”理论探讨辛味药在痛风性关节炎治疗中的应用  

Based on theory of Xuanfu Qiye application of pungent drugs in treatment of gouty arthritis

作　　者：周琨 何东初 杨琦 ZHOU Kun;HE Dongchu;YANG Qi(First Clinical College of Hubei University of Traditional Chinese Medicine,Wuhan 430060,China)

机构地区：[1]湖北中医药大学第一临床学院,湖北武汉430060 [2]解放军中部战区总医院,湖北武汉430070 [3]武汉市红十字会医院,湖北武汉430024

出　　处：《陕西中医》2024年第11期1517-1520,共4页Shaanxi Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(81873153,81273905);湖北省中医药管理局中医药重点项目(ZY2023Z010)。

摘　　要：痛风性关节炎是一种常见的炎性关节疾病,临床以受累关节反复剧痛,红肿发热,功能障碍,甚则畸形为主要表现,病情反复,证候多变,后期常影响肾脏功能。玄府是中医学对人体微观结构的认识,具有形态微细、数量众多、遍布周身的特点,为气液升降出入之门户,对气液宣散、沟通、交换起着重要作用。玄府以开为顺,开阖失司则精微不布,化痰生湿而致痛风。辛味药具有能化、能补、能润、能通、能升的特性,可开玄启闭,宣通气液。本文基于玄府气液学说,并结合痛风性关节炎的临床特点,提出了正虚邪犯,玄府壅塞是始发因素。气液失司,化湿生热为关键病机;痰瘀搏结,耗气伤津为中心环节;玄府失充,迁延反复乃病理结局。临床上灵活使用辛味药化湿、清热、剔痰、祛瘀、补虚,使玄府得通,气液畅达,以期从中医微观层面为辛味药开通玄府,治疗痛风性关节炎提供新视角。Gouty arthritis is a common inflammatory joint disease,characterized by recurrent severe pain,redness,swelling,fever,functional impairment,even deformities in affected joints.The condition was recurrent,syndrome variable and affects renal function in the later stage.Xuanfu was traditional Chinese medicine understanding of the microstructure of human body,characterized by its fine morphology,numerous quantities,and coverage throughout body.It serves as gateway for the flow of gas and liquid,playing an important role Xuanfu prioritizes opening and closing,while opening and closing without proper attention to detail can lead to the transformation of phlegm and dampness,resulting in gout.Spicy drugs have characteristics of being able to transform,replenish,moisturize,unblock and elevate.They can open and close mysteries,promote flow of gas and liquid.Based on the Xuanfu gas liquid theory and combined with clinical characteristics of gouty arthritis,proposing that the disease is characterized by the invasion of positive Qi,deficiency,and evil,with Xuanfu obstruction as initiating factor.The key pathogenesis is the loss of gas and liquid,and transformation of dampness and heat generation.Phlegm stasis and consuming gas and damaging fluids were the central factors that affect the body’s function.The pathological outcome is the loss of power in the Xuanfu and the repeated extension.It is flexible to use spicy medicine to dispel dampness,clear heat,remove phlegm,remove blood stasis and supplement deficiency,so as to make the Xuanfu clear and gas and liquid flow unobstructed,in order to provide new perspective for treatment of gouty arthritis with spicy medicine from micro level of traditional Chinese medicine.

关 键 词：痛风性关节炎 玄府气液 辛香流气 辛润通络 辛味药 开玄通络 

分 类 号：R593[医药卫生—内科学]