中医治疗类风湿性关节炎的药物探讨

Retrospective Research on TCM Formulas for Rheumatoid Arthritis Treatment

目的:通过对现代医家运用中医治疗类风湿性关节炎的系列方剂进行归纳性的回顾,探讨其治疗的核心药物,以期提高中医药方药理论与医疗实践的水平。方法:选取近20年的核心医学期刊和相关的中医药书籍,从中收集中医治疗类风湿性关节炎的组方340首。依据中医病因病机学理论和方药学理论,结合现代研究成果,统计分析所使用的药物。结果:统计结果中前25味药的累积使用频次超过了2073次,累积频率已达到了50%,为核心药物。在这25味药中,补虚药5味,使用频率达13.60%;祛风湿药5味,使用频率达10.68%;解表药5味,使用频率达8.45%;活血化瘀药4味,使用频率达6.89%;平肝熄风药3味,使用频率达6.31%;清热药2味,使用频率达2.77%;利水渗湿药1味,使用频率达1.63%。结论:补虚药、祛风湿药、解表药以及活血化瘀药在现代医家治疗类风湿性关节炎的系列方剂中占主导地位,可为进一步探讨和发展类风湿性关节炎的治疗提供理论依据和基础。

Objective：Through the retrospective research of the series of formulas applied in rheumatoid arthritis （RA） treatment by contemporary doctors, determine core formulas so as to improve theoretical and clinical levels of Chinese medicine. Methods： Under the guidance of traditional pathogenesis and formula theory as well as modem research findings, perform statistic analysis on 340 RA-treating formulas reported in core medical journals/TCM hooks of the past two decades. Results ：Twenty five formulas were identified as core formulas, totaling 2073 usage and accumulative frequency （F） over 50% ： 5 tonics （ F = 13.6% ）, 5 wind-dampness eliminating formulas （ F = 10.68% ）, 5 exterior releasing formulas （ F = 8.45% ）, 4 blood activating formulas （ F = 6.89% ）, 3 liver pacifying formulas （ F =6.31% ）, 2 heat clearing formulas （F =2.77% ）, 1 urine promoting formulas （F = 1.63% ）. Conclusion：TCM formulas of tonics, or wind-dampness eliminating, or exterior releasing, or blood activating functions are predominantly used in RA treatment, which provides theoretical basis for future RA treatment.