大动脉炎中医证治阐微

Traditional Chinese Medicine Management of Takayasu’s Arteritis

目的大动脉炎古无记载,是现代临床难治病,累及多系统,病情复杂,预后多有不佳。现代医学尚阙有效治疗,整理发掘中医辨治方法可为临床实践爰以砖瓦。方法系统回顾整理古今文献,立足中医藏象理论和证素辨证,结合临床从理、法、方、药四个方面进行分析阐释和总结。结果首次提出本病其宿根为血府伏火,病机为本虚标实,以肾阴虚为本,标为热毒、瘀血、气滞、痰浊等相兼为患。临证辨治需立足本虚标实之质,不忘血府伏火,兼顾护脾肾,结合证素辨证,并总结了相关方药。结论中医辨治大动脉炎能有效改善临床症状,延缓病程进展,进一步地挖掘整理于临床有重要现实意义。

Objective To benefit the clinical practice for this multiple-systems-involving-disease, by exploring TCM therapies, with poor prognosis. Without specific interventions, Takayasu’s arteritis which has never been documented in ancient medical books is difficulty to be treated in modern clinical practice.Methods We systematically reviewed of ancient and modern literature, interpreting the TCM treating principles, methods, formulae and herbs based on the theory of traditional Chinese medicine and syndrome and element differentiation.Results We first proposed the ben(rootedpathogenesis) of this disease was yin deficiency of kidney, the rooted-pathogenesis was the hidden-fire in the house of blood(Xue Fu), the biao(clinical manifestations) was heat-toxin, blood stagnation, qi stagnation and phlegm damp complex. So emphasis should be placed on the syndrome differentiation and treatment based on ben deficiency and biao excess, hidden-fire in the house of blood, regulating and nursing spleen-stomach when clinical practicing. And we also summarized some formulae and prescriptions.Conclusion TCM therapy can improve the clinical symptoms and delay the progress of arteritis, further exploration has important practical guiding significance.