吴生元治疗肌痹经验撷要

Summary of WU Shengyuan′s Experience on Treating Muscle Arthritis

目的总结吴生元教授治疗肌痹的经验与心得。方法通过对吴生元教授临床诊治肌痹病案的整理总结,分析其在肌痹治疗上临床遣方用药的特点及常见证型。结果吴生元教授认为肌痹的基本病机是正虚不能御邪,风寒湿热之邪侵袭肌腠,留滞于肌肉关节,脉络闭阻,气血运行不畅,遂出现皮肤红斑,局部肌肉关节疼痛。病程初期以祛邪为主,扶正为辅,多调补肺脾;病程后期以扶正为主,祛邪为标,重视补益肝肾。脏腑辨证以脾为主,病因辨证以湿为主。治疗肌痹注重邪气偏盛转化辨治,审证查因,祛邪为先;强调顾护先后天,调护脾胃贯穿治疗始终。根据临床经验分为风热伤肺证、寒湿痹阻证、湿毒化热证、气虚血瘀证、气血亏虚证、上热下寒证、脾肾阳虚证论治。结论吴生元教授在肌痹治疗上临床疗效颇验,值得学习。

Objective To summarize Professor WU Shengyuan′s experience on treating myoarthralgia.Methods Through the summary of professor WU Shengyuan′s clinical diagnosis and treatment of myoarthralgia,the characteristics and common evidences of clinical prescriptions in myoarthralgia treatment were analyzed.Results Professor WU Shengyuan believes that the basic pathogenesis of muscle arthralgia is that the deficiency of vital Qi can not resist the evil.The evils of wind-cold,dampness and heat invade the muscle,stagnate in the muscle joints,obstruct the veins and the blood flow is not smooth,resulting in skin erythema and local muscle joint pain.At the early stage,the main method is to dispel pathogenic factors,supplemented by strengthening the vital Qi,and regulate and supplement lung and spleen.In the later stage,we should focus on strengthening the body and eliminating pathogenic factors,and pay attention to tonifying liver and kidney.Spleen is the main factor of Zang-Fu syndrome differentiation and dampness is the main cause of syndrome differentiation based on causes.In the treatment of muscular arthralgia,we should pay attention to the transformation of excessive evil Qi,verify and investigate the causes,and eliminate the evil first.It is emphasized that kidney and spleen-stomach should be paid attention to and the spleen and stomach should be regulated throughout the treatment.According to clinical experience,it can be divided into wind-heat injuring lung syndrome,cold-dampness obstructing syndrome,dampness-toxin transforming heat syndrome,Qi deficiency and blood stasis syndrome,Qi and blood deficiency syndrome,upper heat and lower cold syndrome and Yang deficiency of spleen and kidney syndrome.Conclusion Professor WU Shengyuan′s experience on treating myoarthralgia has proved clinical effect and is worthy of learning.