风药论治类风湿性关节炎的理论探析

Theoretic Analysis of Herbal Medicines of Wind Damp Category in the Treatment of Rheumatoid Arthritis

类风湿性关节炎是一种病因未明的以炎性滑膜炎为主的系统性自身免疫疾病,以慢性、进行性、对称性多关节炎症和骨质破坏为主要病理特征。正气不足、肝脾肾亏虚是其发病的内在基础,邪气痹阻为病机根本,痰饮、瘀血为主要病理产物,病变部位多累及筋骨、关节、肌肉,甚则内舍入脏腑,病性为本虚标实、虚实夹杂。风药论治类风湿性关节炎契合其病因病机,且具有多重内涵,可发散达表,祛邪外出;升阳化气,健脾除湿;畅气调肝,活血通络;辛散宣通,布津润燥;轻扬助补,动静相宜;通窍启闭,开通玄府。临证使用之际,当依据类风湿性关节炎临床实际,辨证选用风药。

Rheumatoid arthritis is the systemic autoimmune disease manifested chiefly as inflammatory synovitis. Its etiology is unknown. The pathological characteristics include chronic,progressive and symmetric multi-joint inflammation and bone destruction. Insufficiency of antipathogenic qi and deficiency of liver,spleen and kidney are the internal reason of the disease occurrence. The blockage of pathogenic factors is the root pathology. Phlegm and stasis are the pathological products. Tendons,bones,joints and muscles are involved,even zangfu organs. The nature of the disease is the deficiency of the root cause and the excess of the symptoms,as well as the mixture of deficiency and excess. The principles of the treatment with the herbal medicine of wind damp categories are coincident with the etiology and pathogenesis of the disease. These herbal medicines eliminate the pathogenic factors from the exterior,elevate yang qi,strengthen spleen,remove damp,regulate liver qi,activate blood circulation in collaterals,distribute body fluids. These herbal medicines are used in response to clinical differentiation of rheumatoid arthritis.