马桂琴从“痹痿同病”论治风湿病

Ma Gui-qin′s Experience of Treating Rheumatism Based on"Arthralgia and Flaccidity Being the Same Disease"

马桂琴教授认为,痰瘀胶结伤筋损骨,筋伤则筋纵不能自收持,骨伤则骨痿是风湿病临床中痹痿同病的根本病机。马教授认为,因痿致痹以补为要,因痹致痿以通为要,"痹痿同病"均可见肝肾不足、脾胃虚弱、气血两亏,均要佐以补虚扶正,补脾益肾以固根本。马教授认为,凡病不论病位浅深,病程长短,均有气血流通受阻,气血失和因素在内,既调畅三焦,又从六经运动的角度,调畅阴阳运动之枢机,从而提出治疗"痹痿同病"要善用柴胡剂及四逆散。马教授还重视调和营卫,常运用桂枝汤。

Professor Ma Gui-qin thinks believes that phlegm and blood stasis cementation can damage tendons and bones.Damaged tendons make tendons fail to be self-contained,and bone injuries can lead to bone flaccidity,which is the fundamental pathogenesis of arthralgia and flaccidity in rheumatism clinical practice.According to Professor Ma,the treatment should focus on supplementing for arthralgia caused by flaccidity,while dredging for flaccidity caused by arthralgia."Arthralgia and flaccidity being the same disease"is manifested as insufficient liver and kidney,weak spleen and stomach,qi-blood deficiency.It is necessary to supplement deficiency and strengthen healthy qi,and nourish the spleen and replenish the kidney to strengthen the foundation.Professor Ma believes that all diseases,regardless of the depth of the disease location and the duration of the disease,have blocked the circulation of qi and blood,which leads to disharmony of qi and blood.Therefore,it is necessary not only to regulate the triple energizer,but also smooth the hubs and mechanisms of yin and yang movement from the perspective of six meridians movement.So she puts forward that"arthralgia and flaccidity being the same disease"should make good use of Bupleurum Decoction and Frigid Extremities Powder.Professor Ma also attaches importance to reconciling nutrient and defense qi and often uses Cinnamon Twig Decoction.