基于伏邪学说辨治类风湿关节炎

Differentiation and treatment of rheumatoid arthritis according to theory of latent pathogens

类风湿关节炎发病具有伏邪致病的特点:患者正气亏虚及素体寒湿或湿热是决定发病的内在因素和先决条件;感受六淫邪气为标,且以风寒湿热邪气为主;隐匿潜伏,遇感而作、因加而发为其临床特征。因此,基于伏邪学说可指导类风湿关节炎的辨治,包括避免六淫邪气,及早治疗,使邪无所藏;补益正气,调理体质,使邪无依附;隐匿阶段"先证而治",截断扭转。这体现了治未病的思想,对于提高临床疗效,减少骨破坏的发生,降低致残率具有重要意义。

Rheumatoid arthritis（ RA） takes on the characteristics of diseases due to latent pathogens.Essential qi deficiency is an internal factor,and ordinary factors of cold-dampness or damp-heat are preconditions of diseases due to latent pathogens. The six excesses are external pathogenic factors and pathogens of wind-cold and damp-heat are main pathogenic causes. The clinical characteristics of diseases due to latent pathogens are reflected in hiding and incubation,and aggravating factors will cause the diseases attack. The theory of latent pathogens can guide the diagnosis and treatment of RA,including avoiding six excesses and early treatment for getting rid of latent pathogens,and tonifying healthy qi and regulating constitution for truncating and reversing disease through starting treatment at asymptomatic stage, which reflects the thought of preventive treatment of disease. It is of great significance to improve clinical efficacy,decrease the occurrence of bone destruction and reduce disability rate.