郑洪新教授治疗尪痹(复发性多软骨炎)临床经验  

Prof.Zheng Hongxin's Clinical Experience in Treating Arthralgia(Recurrent Polychondritis)

作　　者：耿新冉 杨硕[2] 郑洪新[1] GENG Xinran;YANG Shuo;ZHENG Hongxin(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China;The Fourth Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110101,Liaoning,China)

机构地区：[1]辽宁中医药大学,辽宁沈阳110847 [2]辽宁中医药大学附属第四医院,辽宁沈阳110101

出　　处：《辽宁中医药大学学报》2025年第5期137-141,共5页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：国家中医药管理局全国名老中医药专家传承工作室建设项目(国中医药人教发[2022]75号);国家中医药管理局第六批全国老中医药专家学术经验继承人项目(国中医药人教发[2017]29号);中国中医药研究促进会基金项目(中医促会[2022]109号);辽宁省中医大师传承工作室基金项目(辽中医药发[2022]1号)。

摘　　要：复发性多软骨炎是一种自身免疫性疾病,现代医学对该病的病因及发病机制尚未明确,临床上多采用糖皮质激素和生物抑制剂来进行干预,但效果一般。中医通过辨证论治,对复发性多软骨炎的治疗有一定的优势。郑洪新教授将其归属为“尪痹”的范畴。尪痹本质以气血不足、脏腑亏虚为主,风寒湿热多为发病的诱因。病位在骨节、肌肉、膜原,本在肝、肾、脾等脏;病性属本虚标实,以虚为主,肝肾亏虚、脾失健运;标实为寒、湿、痰、瘀,或兼风、热等。初则在气血,病所在肌表关节;久则在脏腑,病所在筋骨膜原。尪痹辨证,首以虚、实为纲,辨析虚中夹实,或实中夹虚,或虚实并重;次辨寒、热,寒者当辨实寒、虚寒,热者当辨湿热、风热;再辨兼夹湿、痰、瘀之有无。治疗方面,郑洪新教授采取内外结合的治法。内治法以补益肝肾、调养气血为本,化湿散寒、祛痰化瘀、疏通经络为标,标本兼治;外治法通常嘱患者药渣再煎,浸泡手足,或塌渍局部。该文对郑洪新教授辨证论治尪痹(复发性多软骨炎)的临床经验进行整理,为临床提供新的途径。Recurrent polychondritis is an autoimmune disease.Modern medicine has not yet clarified the etiology and pathogenesis of this disease.Glucocorticoids and bioinhibitors are used in clinical intervention,but the effect is not good.Traditional Chinese medicine has certain advantages in the treatment of recurrent polychondritis through syndrome differentiation.Professor ZHENG Hongxin classifies it as“arthralgia”.The essence of arthralgia is mainly deficiency of Qi and blood and deficiency of Zang-Fu organs,and wind cold and dampness heat are the causes of the disease.The disease is located in the bone,muscle,membrane,the original in the liver,kidney,spleen and other viscera;The disease is characterized by deficiency,deficiency of liver and kidney,and loss of health transport of spleen;The standard is cold,dampness,phlegm,stasis,or combined wind,heat and so on.The initial condition is Qi and blood,the disease is located in the muscle surface joint;For a long time in the Zang-Fu,the disease is located in the bone membrane.Through analyzing the syndrome,the first step is to distinguish between deficiency and reality,and distinguish the deficiency in deficiency,deficiency in deficiency,or both deficiency and excess.Second distinguish cold,heat,cold should distinguish solid cold,deficiency cold,hot should distinguish damp heat,wind heat;Then distinguish the presence and absence of dampness,phlegm and stasis.In terms of treatment,Professor ZHENG Hongxin adopts a combination of internal and external treatment.The internal treatment is based on tonifying liver and kidney,regulating Qi and blood,clearing dampness and dispelling cold,expelling phlegm and removing stasis,dredging channels and collaterals.External treatment usually tells the patient to decocte the residue again,soak the hands and feet,or collapse the local stain.In this paper,the clinical experience on syndrome differentiation and treatment of recurrent polychondritis was summarized to provide a new way for clinical purposes.

关 键 词：复发性多软骨炎 尪痹 临床经验 名老中医 

分 类 号：R255.6[医药卫生—中医内科学]