从五脏探讨银屑病性关节炎病因病机

Discussion on Etiology and Pathogenesis of Psoriatic Arthritis from Five Viscera

银屑病性关节炎(PsA)是一种与银屑病相关的炎性关节病,属中医“痹证”范畴,现代医学认为其发病与基因-环境相关,现代医学对该病的治疗尚不能达到满意效果。中医强调整体观念,认为人体内部脏腑的病变会在体表(外)有迹可循,即“有诸内必形诸外”。五脏作为一个有机整体,相互联系亦相互影响,并能通过形体诸窍维系内外环境的平衡。文章从五脏生理、病理特点出发探讨其与PsA发病关系,认为该病属虚实夹杂,五脏功能失调是导致PsA发病的重要原因,强调内外并重的发病观,治疗上在祛除外邪基础上还应注重五脏的调护。

Psoriatic arthritis is an inflammatory arthropathy related to psoriasis,which belongs to the category of“arthralgia”syndrome in traditional Chinese medicine.Modern medicine believes that its onset is related to gene-environment,and the treatment of this disease by modern medicine cannot achieve satisfactory results.Traditional Chinese medicine(TCM)emphasizes the whole concept,and holds that the pathological changes of internal organs of human body can be traced on the surface(outside),that is,“what is inside must be shaped outside”.As an organic whole,the five internal organs are interrelated and influence each other,and can maintain the balance of internal and external environment through the orifices of the body.Based on the physiological and pathological characteristics of the five internal organs,this paper discussed the relationship between the five internal organs and the pathogenesis of psoriatic arthritis,and held that the disease is a mixture of deficiency and excess,and the dysfunction of the five internal organs is an important cause of the pathogenesis of psoriatic arthritis,emphasizing the concept of paying equal attention to both internal and external factors,and paying attention to the care of the five internal organs on the basis of eliminating external evils in treatment.