刘健运用健脾滋阴清热法治疗阴虚燥热型成人斯蒂尔病经验  

Liu Jian′s experience in the treatment of adult-onset Still′s disease with Yin deficiency and dryness-heat syndrome by invigorating spleen,nourishing Yin and clearing heat

作　　者：胡月迪 刘健[1] 孙玥[1] 周巧 Hu Yuedi;Liu Jian;Sun Yue;Zhou Qiao(Anhui Provincial Hospital of Traditional Chinese Medicine,Hefei Anhui 230031;Anhui University of Chinese Medicine,Hefei Anhui 230012)

机构地区：[1]安徽省中医院,安徽合肥230031 [2]安徽中医药大学,安徽合肥230012

出　　处：《山西中医药大学学报》2025年第1期69-74,共6页Journal of Shanxi University of Chinese Medicine

基　　金：国家高水平中医药重点学科中医痹病学(国中医药人教函[2023]85号)。

摘　　要：成人斯蒂尔病(AOSD)是一种发病机制、发病原因均不明确的系统性免疫性炎症性疾病,其发病可能涉及遗传基因、先天免疫和获得性免疫等多个环节,如不同遗传基因的易感性、通过基因谱系标记物激活炎症反应的先天免疫激活、通过炎症细胞因子相互作用和巨噬细胞极化进行的适应性免疫激活等。AOSD以反复高热,一过性皮损,咽痛,关节痛或关节炎,淋巴结或肝脾肿大为主要临床特征,实验室指标多伴有白细胞、中性粒细胞比例升高,高铁蛋白血症,肝功能异常等。中医学认为AOSD属“热痹”范畴,因正气亏虚,风、寒、湿等外邪趁虚侵袭腠理,潜伏体内,阳气阻滞,气郁化火,伏邪泛滥而发病。刘健教授认为,AOSD因脾虚湿盛,久而耗气伤阴,阴虚燥热与湿热痰瘀互结,呈现虚实夹杂之象,临床治疗以滋阴清热与健脾化湿并举,将从脾治痹的原则贯穿治疗始终,总以二陈汤为组方之魂,疗效显著,对中医学治疗AOSD具有参考意义。Adult-onset Still′s disease(AOSD)is a systemic immune inflammatory disease with unclear pathogenesis and etiology.Its onset may involve multiple links such as genetic genes,innate immunity and acquired immunity.Susceptibility to different genetic genes,innate immune activation through gene lineage markers to activate inflammatory responses,adaptive immune activation through inflammatory cytokine interactions and macrophage polarization can all contribute to its pathogenesis.The main clinical features of AOSD are repeated high fever,transient skin lesions,sore throat,joint pain or arthritis,enlarged lymph nodes or enlarged liver and spleen.Laboratory indicators are mostly accompanied by increased white blood cells and proportion of neutrophils,hyperferritinemia,and abnormal liver function,etc.Traditional Chinese medicine believes that AOSD belongs to the category of“re bi”.Due to deficiency of healthy-Qi,external pathogenic factors such as wind,cold,and dampness invade the striae when the body is weak and then lurk in the body.Yang-Qi is blocked,Qi stagnation turns into fire,and latent pathogenic factors overflow and cause the disease.Professor Liu Jian believes that AOSD is caused by spleen deficiency and excessive dampness.Over time,it consumes Qi and injures Yin.Yin-deficiency and dryness-heat are intertwined with dampness-heat,phlegm and blood stasis,presenting a mixed picture of intermingled deficiency and excess.In the clinical treatment,the combination of nourishing Yin and clearing heat and strengthening spleen and resolving dampness is used.The principle of treating bi-disease from the spleen will be used throughout the treatment.Erchen Decoction is the soul of the prescription and has significant curative effect,which has reference significance for the treatment of AOSD with traditional Chinese medicine.

关 键 词：成人斯蒂尔病 滋阴清热 刘健 

分 类 号：R249[医药卫生—中医临床基础] R259[医药卫生—中医学]