李兆福基于脾为浊源理论辨治痛风临证思路探析  

Analysis of LI Zhaofu′s Thinking on Distinguishing Clinical Symptoms of Gout Based on Theory of Spleen As Turbidity Source

作　　者：段蕊 谢招虎 杜时雨 郗域江 肖妮沁 刘晓丽 李兆福 DUAN Rui;XIE Zhaohu;DU Shiyu;XI Yujiang;XIAO Niqin;LIU Xiaoli;LI Zhaofu(Yunnan University of Traditional Chinese Medicine,Kunming 650500,Yunnan,China;The First Affiliated Hospital of Yunnan University of Chinese Medicine,Kunming 650021,Yunnan,China)

机构地区：[1]云南中医药大学,云南昆明650500 [2]云南中医药大学第一附属医院,云南昆明650021

出　　处：《辽宁中医杂志》2025年第4期28-31,共4页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(82260925);云南省重点研发计划项目(202005AF150017);云南省基础研究计划青年项目(202201AU070164);云南省科学技术厅-云南中医药大学应用基础研究联合专项面上项目(202101AZ070001-018);云南省科学技术厅-云南中医药大学应用基础研究联合专项面上项目(202101AZ070001-241);云南省“万人计划”名医专项(2019);云南省重大科技计划生物医药专项项目(202102AA310006);云南省高层次科技人才及创新团队选拔专项项目(202305AS350007)。

摘　　要：痛风是临床多发病、常见病,李兆福教授将其分为急性期、间歇期和慢性期,认为不同时期病机不同,急性期由于患者素体脾虚,湿邪内生,加之复感外邪或饮食不节,助湿生热,热盛化毒,流注于关节经络,致气血闭阻不通而发病;间歇期及慢性期,在于脾虚湿阻或痰瘀湿邪相互搏结,酿生“污浊”,流于关节肌肉或藏于肾脏。其中“湿、痰、瘀”是导致痛风发病的基础病理因素,而这些“浊邪”产生根本源于脾虚失职。故李教授提出“脾为浊源”的理论,临证治疗中,以健运脾胃为大法,准确及时抓住机体病机发展,针对性配伍清热养阴、化痰散结、活血通络等治法,临床疗效显著。Gout is a common and frequently occurring disease in clinical practice.Professor LI Zhaofu divides it into acute stage,intermittent stage and chronic stage,believing that the pathogenesis is different in different periods.In the acute stage,due to the spleen deficiency,the endogenous dampness,compounded exogenous evil or improper diet,the dampness can generate heat,and excessive heat can transform toxin,which flows into the joints and meridians and causes the blockage of Qi and blood.In the intermittent period and chronic period,the struggle between spleen deficiency and dampness or between phlegm and stasis and dampness brews“dirty”,flowing in the joints and muscles or hidden in kidney.Among them,“dampness,phlegm and blood stasis”are the basic pathological factors leading to the onset of gout,and these“turbid evils”is caused by spleen deficiency.Therefore,Professor Li has put forward the theory of“spleen as the turbid source”.In the clinical treatment,strengthening spleen and stomach is the principle method,accurately and timely grasping the pathogenesis development,the targeted combination of clearing heat and nourishing Yin,resolving phlegm and dispersing mass,activating blood and dredging collateral methods.The clinical effect is remarkable.

关 键 词：痛风 病因病机 健运脾胃 分期论治 

分 类 号：R249[医药卫生—中医临床基础]