基于“祛瘀通痹”治则的类风湿性关节炎中医药治疗研究进展

Research Progress of Rheumatoid Arthritis TCM Therapy Based on the Principle of“Removing Blood Stasis and Dredging Obstruction”

类风湿性关节炎(rheumatoid arthritis,RA)是一种病势反复、缠绵难愈的自身免疫性疾病,病势持久发展会对患者关节造成不可逆转的损害。现代研究表明,RA的发病机制可能与Wnt/β-catenin信号通路异常、成纤维样滑膜细胞(FLS)异常增殖相关。中医理论指出,RA由内、外二因协同作用而发病,患者本虚标实,其RA发病主要在于感染不同类型外邪,导致瘀血阻滞与经络痹塞,故其治则应以祛瘀通痹为主。中医药根据临床辨证分型,并对RA实行随证治疗,疗效确切,对Wnt/β-catenin信号通路的调节作用明显,对不同证型RA均显示出良好疗效,且安全性良好,不良反应发生率较低,与化学药物联用增效明显。文章基于中医理论对RA病理病机的诠释,对近年中医药治疗RA的报道兹以综述,以期为该病在临床实践中更好地应用中医药提供参考。

Rheumatoid arthritis(RA)is an autoimmune disease that recurs and difficult to cure,prolonged development of the disease will cause irreversible damage to the patients’joints.Studies have suggested that the pathogenesis of RA may be related to overexpression of Wnt/β-catenin signaling pathway and abnormal proliferation of fibroblast-like synovial cells(FLS).According to traditional Chinese medicine(TCM),the pathogenesis of RA is mainly due to the synergistic effect of internal and external factors.RA patients are deficiency in origin and excess in superficiality,the onset of RA is mainly caused by infection of different types of exogenous pathogens,which accounts for blood stasis and arthralgia.Thus,treating strategy of RA should focused on blood stasis removement and arthritis alleviation.With clinical syndrome differentiation of RA,TCM manifests efficient effects against RA and effective regulation of Wnt/β-catenin signaling pathway.TCM also presents good curative effect on RA of different syndrome types and promising safety with less adverse reactions.Moreover,the curative effect of chemical drugs can be improved with coordinate administration with TCM.Based on the TCM theory of pathogenesis of RA,the present review reports the TCM treatment of RA in recent years.It provides reference for better utility of TCM in clinical applications against RA.