基于脾主运化理论探讨间歇期及慢性期痛风治疗策略

Treatment Strategy on Gout in Intermittent stage and Chronic Stage Based on the Theory of Spleen Governing Transportation and Transformation

"脾主运化"与机体消化系统及物质代谢的关系极为密切。痛风的发病多为素体脾胃虚弱,嗜食高粱厚味、醇酒海鲜,重伤脾胃,化生痰湿,加之外感风、寒、湿邪,最终导致湿浊痰瘀流注关节肌肉筋脉。故脾主运及主化功能失职,招致内外湿相合,湿浊内阻是间歇期及慢性期痛风的基本病机,湿、浊、痰、瘀是其重要病理因素,而脾虚贯穿整个疾病过程。所以临床以健脾化湿法为主要治法,从"脾主运化"角度论治间歇期及慢性期痛风,将对降低患者尿酸水平、提高疗效、减少痛风性关节炎反复发作有重要意义。

The spleen governing transportation and transformation is closely related to the digestion system and metabolism. The onset of gout is overwhelmingly the result of constitutional spleen-stomach deficiency and preference for greasy and rich foods,alcohol and seafood,because these always injure the spleen and stomach,causing internal phlegm and dampness,and when this condition is further complicated by contraction external evils such as wind,coldness and dampness,the dampness turbidity and phlegm stasis will pour into joints,muscles,tendons and vessels.Therefore,the disorder of the spleen governing transportation and transformation may incur the combination of internal dampness and external dampness. Internally obstructed dampness is the basic pathological mechanism of gout in intermittent and chronic stages. Dampness,turbidity,phlegm and stasis are important pathological factors,while spleen deficiency is what influence through the course of the disease. Therefore,in clinical practice,fortifying the spleen and transforming dampness is the main therapeutic method. To treat gout in intermittent stage and chronic stage based on the theory of＂spleen governing transformation and transportation＂has important significance to reduce uric acid level,improve the curative effect and decrease possibility of disease recurrence.