浅论痰瘀在类风湿关节炎中的致病作用

Discussion on Pathogenesis of Rheumatoid Arthritis by Phlegm and Blood Stasis

类风湿关节炎是临床最常见的风湿免疫病之一,属中医痹病范畴。痰浊、瘀血既是其重要的病理产物,又是其重要的致病因素。痰浊、瘀血同源同因又相互化生,两者密切相关,并在痹病的发生发展中都发挥着重要作用。现代研究不断揭示了痰瘀形成的物质基础、痰瘀相关的本质,以及痰瘀在类风湿关节炎发病机制中的重要作用。化痰通络方能有效治疗类风湿关节炎,临床与动物实验证实其能有效降低血清中血管内皮生长因子（VEGF）的表达。抑制VEGF介导的血管增生可能是化痰通络方治疗类风湿关节炎的主要机制。

Rheumatoid arthritis（ RA） is one of the most common clinical autoimmune diseases,which belongs to arthralgia syndrome in Traditional Chinese Medicine. In arthralgia syndrome,both phlegm and blood stasis are significant pathological products and pathogenic factors. The phlegm and blood stasis are due to homologous and mutually metaplasia. It is precisely due to the close relationship,and each of them plays a vital function in the occurrence and development of arthralgia syndrome. Modern researches reveal the biology foundation and the essential relationship of phlegm and blood stasis,frequently,as well as the important role of them in the pathogenesis of RA. Huatan Tongluo Fang,a traditional herbal formula,is effective in treatment for RA by resolving phlegm and dredging collaterals. Clinical and animal trails confirmed that it can reduce the expression of VEGF in the serum effectively. Therefore,inhibition of angiogenesis VEGF being mediated might be the key mechanism of Huatan Tongluo Fang in the treatment of RA.