论明清时期对痹证病因病机认识

Discussion on Understanding of Etiology and Pathogenesis of Arthralgia Syndrome in Ming and Qing Dynasties

痹证是中医中最为常见的病症之一,其主要的临床表现为肢体关节及肌肉酸痛、麻木、重着、屈伸不利,甚或关节肿大、灼热等,其病程发展具有渐进性和反复发作性的特点,被称为不死的癌症。中医对痹证的概念很广,与西医的“强直性脊柱炎”“风湿性关节炎”“痛风”等相对应,属于内科慢性疾病,但其造成的影响却很严重。痹证的概念从先秦两汉时期就已提出,发展至明清时期,中医对痹证的阐述已非常完善,现通过相关文献系统分析,整理出明清时期对痹证的病因病机认识的中医理论框架结构,为现代医家深入的认识此病奠定了良好的基础。文章主要对明清时期的重要书籍包括《金匮翼》《类证治裁》《临证指南医案》《医门补要》《杂病源流犀烛》《校注医醇滕义》《病因脉治》《症因脉治》等进行了讨论分析,整理出明清时期对痹证因机的认识。

Arthralgia syndrome is one of the most common syndromes in traditional Chinese medicine,and its main clinical manifestations are limb joint and muscle pain,numbness,heavy,poor flexion and extension,or even joint swelling,burning,etc..The arthralgia syndrome has the characteristics of progressive or recurrent seizures,therefore it is called deathless cancer.Arthralgia syndrome in traditional chinese medicine has a wide concept,which corresponds to rheumatoid arthritis,gout and ankylosing spondylitis in Western medicine.Arthralgia syndrome is a chronic disease in internal medicine,but its influence is very serious.The concept of arthralgia syndrome has been proposed since pre-Qin,han and han dynasties,and has been well expounded in TCM since its development to Ming and Qing dynasties.Through systematic analysis of relevant literatures,the theoretical framework of arthralgia syndrome in TCM in Ming and Qing dynasties is sorted out,which lays a good foundation for modern doctors to have a deeper understanding of arthralgia syndrome.The main chinese literatures from the Ming and Qing dynasties of TCM are discussed in this paper,and summarizes the understanding about etiology and pathogenesis of arthralgia syndrome in Ming and Qing dynasties.