基于湿热浊瘀互结复合病机探讨痛风的诊治策略

Discussion on Diagnosis and Treatment Strategy of Gout Based on Combined Pathogenesis of Dampness-heat, Turbidity and Blood Stasis

本文从中医湿热浊瘀互结复合病机探讨痛风的诊治策略,认为湿热浊瘀胶结于肢体经脉骨节为关键病机,脾胃、三焦、肝肾功能失调虚实夹杂为其本。湿热浊瘀互结始终贯穿于痛风病的急性发作期、间歇期、慢性期。急性期以湿热浊郁结肢体经脉骨节气分为主初涉血分;间歇期湿热浊瘀胶结于肢体经脉骨节血分,气血同病;慢性期不仅肢体经脉骨节湿浊痰瘀胶结,而且脾胃、三焦、肝肾脏腑气血阴阳亏虚,邪气入里,形成表里虚实气血阴阳错杂危重的病变。

This article discusses the diagnosis and treatment strategy of gout from the complex pathogenesis of damp-heat turbidity and blood stasis in traditional Chinese medicine. It holds that the key pathogenesis is the binding of damp-heat turbidity and blood stasis to meridians and joints of limbs, and the deficiency and excess of the dysfunction of spleen and stomach, triple energizer, liver and kidney are its essence. Dampness-heat, turbidity and blood stasis always run through the acute, intermittent and chronic phases of gout. At the acute stage, the blood involved was mainly the bone and solar terms of the meridians of the limbs due to damp-heat and turbid stagnation. During the intermission period, damp heat, turbidity and blood stasis were cemented in the joints and joints of the meridians of the limbs, resulting in the same disease of qi and blood. In the chronic stage, not only the joints of the limbs and meridians are wet, turbid, phlegm and blood stasis cemented, but also the spleen and stomach, triple energizer, liver and kidney viscera are deficient in qi and blood, yin and yang, and pathogens enter, resulting in a serious disorder of qi, blood and yin mixed with exterior and interior excess and deficiency.