类风湿关节炎中西医治疗进展

Advances in Traditional Chinese and Western Medicine for Rheumatoid Arthritis

类风湿关节炎是一种以对称性、侵蚀性关节炎为主要表现的自身免疫性疾病。多见于30~50岁女性,其症状和并发症严重影响患者生活质量。发病机制尚未完全明确,免疫紊乱被认为是可能的发病机制。临床症状复杂多变,除关节外,可累及心、肺、肾、神经系统等器官或组织。类风湿关节炎属中医"痹证"范畴,认为其发病是由于素体虚弱,外邪侵袭人体,留滞于内,导致痰瘀阻滞经脉,气血运行不畅,久病易致肝肾亏损,关节肌肉失养。治疗方法分西医治疗与中医治疗,西医多用非甾体类抗炎药、抗风湿药、糖皮质激素、生物制剂、小分子靶向药等药物治疗或手术等非药物治疗,中医治疗上多用中药提取物、中药汤剂、针灸、拔罐、针刀、蜂针等。中西医各具特点及优势,临床强调个体化治疗、联合用药及优势互补。

Rheumatoid arthritis is an autoimmune disease characterized by symmetrical and aggressive arthritis. It is common in women aged 30-50,and symptoms and complications seriously affect the patients’ quality of life. The pathogenesis is not fully understood,and immune disorders are considered as possible pathogenesis. Clinical symptoms are complex and changeable,except joints,may involve the heart,lung,kidney,nervous system and other organs or tissues. Rheumatoid arthritis belongs to the category of traditional Chinese medicine"Bi syndrome",and it is believed that its onset is due to the weakness of the body,cold,dampness,heat and other external evil invasion of the body,stay in the internal lead to phlegm and blood blocking meridians,Qi and blood flow is not smooth,and lead to pain,long illness is easy to cause liver and kidney loss,joint muscle loss. The treatment methods are divided into Western medicine treatment and traditional Chinese medicine treatment. Western medicine uses non-steroidal antiinflammatory drugs,anti-rheumatic drugs,glucocorticoids,biological agents,small molecule targeted drugs and other drug treatment or non-drug treatment such as surgery,while traditional Chinese medicine treatment uses traditional Chinese medicine extracts,traditional Chinese medicine decoction,acupuncture,cupping,acupotomies,bee needles and so on. Traditional Chinese and Western medicine have their own characteristics and advantages,emphasizing individualized treatment,combined medication and complementary advantages.