从当归拈痛汤探讨湿热痹阻型类风湿关节炎的组方配伍

Discussion on The Prescription Compatibility of Rheumatoid Arthritis of Dampness Heat Obstruction Type by Danggui Niantong Decoction

目前针对类风湿关节炎中药配伍规律的研究多是运用数据挖掘技术寻找各种高频药物或常用药物配伍,但并无详细阐述其配伍意义。因此本文以治疗类风湿关节炎常用方剂之一的当归拈痛汤为例,深入探讨中医对于类风湿关节炎的认识和中药配伍,以期为临床治疗提供传统中药药理思路。总结得出中医对类风湿关节炎病因病机的认识包括2个方面,即正虚为本,邪实为主,且实邪以湿邪为重、湿热相合兼外感风邪。并从本方创始人张元素的药物分类思路出发,结合传统中药药理理论,详细分析方中各类药物之间配伍的意义,得出当归拈痛汤对于湿热痹阻型类风湿关节炎的配伍内涵为:以风升生药祛风除湿,以寒沉藏类药清热祛湿,以湿化成类药强基固本,以燥降收类药加强祛湿之效,从各药组合中可窥见其配伍理法之深刻。

At present,in order to study rheumatoid arthritis(RA),data mining has been widely used in traditional Chinese medicine(TCM)to find rules of compatibility in high-frequency drugs or commonly used medicines.However,the significance of compatibility has not been illustrated so far.Aiming to provide a pharmacological idea of TCM for clinical therapy,we use Danggui-Niantong Decoction(DGNTD)as an example,which is one of the commonly-used prescriptions in treating RA,to explore how to treat RA in TCM.We find that the Etiology and pathogenesis of RA in TCM include two aspects:one is the fundamental reason that is the differenty of the vital,and the other is the main cause that is the excess of the pathogens.Excessive pathogen is mainly made of damp evil,hot and humid condition with heat evil and wind evil.Based on the idea of DGNTD’s founder and the pharmacological theory of TCM,we analyze the significance of drug compatibility in the prescription.Finally we get the mean of compatibility in DGNTD used to treat RA with the syndrome of dampness-heat.In conclusion,the compatibility of drugs has a profound significance,which includes evaporating the wind evil and damp evil by ascend drugs,clearing the heat evil and damp evil by cold and deep drugs,and strengthening the body and the effect of humidity by dry and sink drugs.