辨病与辨证相结合治疗类风湿性关节炎

Treating rheumatoid arthritis with the integration of disease differentiation and syndrome differentiation

辨中医的"证"和"病"强调的是宏观,辨西医的"病"强调的是微观。类风湿性关节炎就现代研究来看有其自身的发病特点,单一的辨证已不能有效把握本病的本质、治疗、转归及预后,必须运用辨病与辨证相合的方法来论治。风寒湿热等外感因素是发病的条件,在本病发展过程中起诱发作用,而肾督阳气亏虚与肝肾阴精不足是类风湿性关节炎发病的根本原因,故而温肾壮督、补益肝肾是本病的治本之道,应贯穿本病治疗始终。辨病同时结合辨证,据风、寒、热之不同,痰、瘀、虚之别,以及邪实正虚矛盾主次之转化进行辨证论治更符合临床实际提高临床疗效。

The ‘syndrome’ and ‘disease’ differentiation in traditional Chinese medicine emphasized the importance of the macroscopic view, while the ‘disease’ differentiation in western medicine pay attention to the microscopic view. The TCM syndrome differentiation could not afford to conduct many factors of rheumatoid arthritis including the nature, treatment, outcome and prognosis due to its own pathogenic characteristics, so it became inevitable to treat the rheumatoid arthritis with the integration of disease and syndrome differentiation. In the progress of rheumatoid arthritis, the wind, cold, dampness, heat and other exogenous factors were thought as the inducing factors, but the deficiency of kidney yang and the yin deficiency of liver and kidney were the primary cause. Thus, the treatment methods, including warming the kidney and strengthening the du meridian, and tonifying and replenishing liver and kidney, were specially used to treat the primary causes that were suggested to run throughout the treatment. So, in order to improve the clinical efficacy, we need to integrate disease differentiation and syndrome differentiation. In the process of the syndrome differentiation, we should attach the importance of pathological factors including the wind, cold, heat, phlegm, blood stasis, deficiency, as well as the nature of the disease transformation between the excessiveness of pathogenic factor and the deficiency of the vital qi.