樊粤光应用虫类药物治疗退行性骨关节炎经验

Experience of FAN Yue-Guang in Treating Degenerative Osteoarthritis with Insect Drugs

退行性骨关节炎可归属中医“骨痹”“痹证”范畴。樊粤光教授认为退行性骨关节炎患者病程较长,久病入络,病邪深伏,草木柔润之剂难以入络,故需采用虫类药以搜剔经络。对于疼痛游走不定的行痹患者,可酌加全蝎、蜈蚣、乌梢蛇;治疗疼痛酸楚不适、肢体沉重的着痹患者,可选用僵蚕、蜈蚣、地龙;对于疼痛剧烈、遇寒加重而得热则减的痛痹患者,可选僵蚕、蜈蚣;治疗局部红肿热痛为特征的热痹患者,可选地龙、水蛭;腰部疼痛明显者可选蜈蚣、乌梢蛇;久病见血瘀者,可加土鳖虫。在临床运用虫类药治疗退行性骨关节炎过程中,还需辨寒热、辨部位、结合现代药理研究结果,并注意减轻虫类药的毒性。

Degenerative osteoarthritis can be classified into the category of “obstructive syndrome of bones”or“blockage syndrome(arthralgia)”. Professor FAN Yue-Guang believes that degenerative osteoarthritis has a long course of illness,which results into the pathogens going into the collaterals and the herbal drugs with the moderate and nourishing actions are difficult to expel the pathogens out. Therefore,Professor FAN Yue-Guang suggested using insect drugs for expelling the pathogens from the meridians and collaterals. For the treatment of migratory arthralgia patients with migratory pain,Scorpio,Scolopendra,and Zaocys can be added into the prescriptions;for the treatment of damp arthralgia patients with aching pain and heaviness in the extremititis, Bombyx Batryticatus, Scolopendra, and Pheretima can be chosen for modification;for the treatment of agonizing arthralgia patients with sharp pain which can become severer when exposing to cold while can be relieved when exposing to heat,Bombyx Batryticatus and Scolopendra can be added;for the treatment of heat arthralgia with local congestion,swelling,heat and pain,Pheretima and Hirudo can be added;for the treatment of patients with severe lumbago,Scolopendra and Zaocys can be added;for the treatment of chronic patients with blood stasis syndrome,Eupolyphaga seu Steleophaga can be added. During the utilization of insect drugs for the treatment of degenerative osteoarthritis, cold-heat syndrome differentiation, foci site distinguishing, modern pharmacological achievement and the measures for relieving the toxicity of insect drugs should be also taken into account.