从毒论治风湿病骨与软骨损害的临床探析

Exploration on the theory of treating bone and cartilage destruction in the rheumatism with the principle of detoxification

骨质与软骨的修复与保护是治疗类风湿关节炎、骨关节炎、痛风性关节炎等风湿病的重难点。风湿病多属于痹证范畴,以"毒痹论"为指导思想,从毒论治此类疾病临床疗效确切。首先围绕"毒"这一核心,从痹证(风湿病)病因、病机关键、主要证候、治法方药等方面分析了痹证的因机证治要点;其后,从骨与关节软骨破坏的病理机制、影像特点、基础研究进展等方面简述了修复和保护骨与关节软骨在风湿病临床中的重要作用;最后,以类风湿关节炎、骨关节炎、痛风性关节炎为代表病种,分别论述了"毒"在其发病与进展中的重要作用,以及从毒论治该病的辨证用药方案,具体阐述从毒论治风湿病骨与软骨损害的理论依据与临床应用。

Treating of rheumatoid arthritis, osteoarthritis and gouty arthritis is the key and difficult points of rheumatism. As the rheumatism belonging to Bi（Paralysis）, based on the toxin Bi theory, the method of treating rheumatism with the principle of detoxification has a definite clinical effect. Firstly, this manuscript kept extending around the core of toxin, and overall analyzed the key points of Bi（rheumatism） from four aspects, such as the etiological factors of paralysis, the key pathogenesis, the main syndromes and the prescriptions and herbs. Secondly, this manuscript sketched the important role of repairing and protecting of bones and articular cartilage in the clinical treating of rheumatic diseases from several aspects of the pathogenesis, image characteristics, basic research progresses of the destructions of bones and cartilage. Last but not least, the key role of toxin in the pathogenesis and progression of the representative paralysis, such as rheumatoid arthritis, osteoarthritis and gouty arthritis, was expounded, as well as the therapeutic regimen with the principle of detoxification. Thereupon then, the theoretical foundation and clinical application of the theory of treating bone and cartilage destruction in the rheumatism with the principle of detoxification can be elaborated specifically.