从“虚、浊、热、瘀”辨证痛风浅谈

Syndrome differentiation of gout based on deficiency,turbidity,heat and blood stasis

目前中医学术界对痛风发病的认识尚未一致。学习先贤理论、治验及阅读大量文献,结合临证实践的体会,认为"虚、浊、热、瘀"是痛风发生发展的病机关键。本病的病因病机为脾肾亏虚,加之平素嗜食膏粱厚味,或饮酒、劳欲过度,日久湿浊内停而发病。脾失健运则升清降浊无权,肾失气化则分清泌浊失司,人体水液不能正常运化,导致湿浊热毒内生,阻于骨骼、经络、关节,致血行不畅,血滞为瘀,浊瘀互结而成。本病以脾肾亏虚为本,湿浊、瘀热痹阻经脉、骨节为标,本虚标实。

At present, the understanding of gout onset has not been consistent in TCM academic circle. The authors thought that the key of gout development included deficiency, turbidity, heat and blood stasis on the base of studying the theory and clinical experience of ancient sages, reading a large number of literature and document, and combining rich clinical practice. The etiology and pathogenesis of gout is deficiency of spleen and kidney complicating with fatty food, drinking, fatigue and excessive sex. Spleen failing in transportation induces the disorder of lucidity ascending and turbidity descending, and kidney failing in qi transformation induces the dysfunction of separating the clear and turbid. Therefore, the fluid and humor in the body cannot be transported and transformed, and dampness, turbidity and heat toxin are produced internally, which obstruct in bone, meridians and joints and cause poor blood flow, blood stasis and binding of turbidity and stasis. The root of gout is deficiency of spleen and kidney, dampness, turbidity, blood stasis and heat obstructing in meridians, and the tip is the symptoms in bone and joints. The syndrome of gout is manifested as deficiency of the root and excess of the tip.