基于“肠-关节轴”浅析“从脾治痹”

An Analysis of"Treatment of Arthralgia from the Spleen"Based on the"Gut-Joint Axis"

中医学认为脾胃失调,骨痹由生,现代医学也发现肠道健康与炎症性关节病密切相关。现代研究发现,肠道菌群失调及肠道屏障功能的受损通过免疫、代谢等途径影响着关节炎的发生、发展和预后,提示关节炎的诊疗过程中尤应注重肠道功能的调理。这与中医学的“从脾治痹”的概念十分相似。“从脾治痹”是近现代中医治疗关节炎的重要思路之一。脾胃亏虚,一方面影响营卫气血生成,风寒湿热易于内侵,骨肉关节失充失撑;另一方面影响气血津液运行,水湿痰瘀继之内生。脾胃功能异常贯穿痹证发病的始终。临床运用健脾利湿类方剂及循脾胃二经选穴针灸治疗痹证均有较好疗效,还可维护肠黏膜屏障、调整肠道菌群,为“从脾治痹”提供了现代医学的理论依据。

Traditional Chinese medicine thinks that bone Bi-disease is caused by dysfunction of the spleen and the stomach,and modern medicine has also found that intestinal health is closely associated with inflammatory joint disease.Modern studies have shown that gut microbiota dysbiosis and intestinal barrier function impairment affect the development,progression,and prognosis of arthritisthrough the pathways including immunity and metabolism,suggesting that regulation of intestinalfunction should be taken seriously in the diagnosis and treatment of arthritis.This is quite similar to the concept of"treatment of arthralgia from the spleen"in traditional Chinese medicine,and this concept has become one of the important ideas for traditional Chinese medicine treatment of arthritis.On the one hand,spleen-stomach deficiency affects the generation of nutrient and defensive Qi-blood,and wind,coldness,and damp-heat may easily invade the human body,which leads to the loss of support in bones,muscles,and joints;on the other hand,spleen-stomach deficiency affects the circulation of Qi-blood and body fluid,which leads to dampness and phlegm stasis.Abnormal spleen-stomach function is observed during the course of arthralgia.In clinical practice,spleen-strengthening and diuresis-promoting prescription and acupuncture with acupoint selection in the spleen and stomach meridians have achieved a good clinical effect in the treatment of arthralgia and can protect intestinal mucosal barrier and regulate gut microbiota,which provides a theoretical basis in modern medicine for"treatment of arthralgia from the spleen".