类风湿关节炎伴间质性肺炎的病机及培土生金解毒通络的治法探讨

Pathogenesis of rheumatoid arthritis with interstitial lung disease and the treatment method of reinforcing earth to strengthen metal,dispelling toxins and dredging collaterals

类风湿关节炎伴间质性肺炎常以咳嗽为首发症状,具有气促、胸满、咯血、局部关节肿胀变形等表现,病程较长,预后较差。中医学将其多归属为“痹证”“肺痹”范畴,为本虚标实、虚实相兼之证,“脾阳虚衰,肺叶失养,毒邪阻络”是类风湿关节炎伴间质性肺炎的主要病机,疾病日久损耗元气。治疗上多提倡“培土生金、解毒通络”法,重视健脾益肺以培元固本;重视化湿解毒以宣通肺络。正气存,肺络通,则疾病向愈。

Rheumatoid arthritis(RA)with interstitial lung disease(ILD)is often the first symptom of cough,with shortness of breath,chest fullness,hemoptysis,local joint swelling deformation and other manifestations with long course of disease and poor prognosis.In traditional Chinese medicine,it is mainly classified as'bi syndrome'and lung bi',which is a syndrome of deficiency in origin and excess in superficislity,both deficiency and excess.‘Spleen yang deficiency and decline,lung lobule loss,poison and evil blocking collaterals'are the main pathogenesis of RA with ILD,and the vitality of the disease is lost over time.In treatment,the method of'cultivating soil to produce gold,detoxifying and dredging collaterals'is advocated,and the spleen and lung are strengthened to consolidate basis.Pay attention to detoxification to disperse lung collaterals.When the vital qi is stored and the lung collaterals are unblocked,the disease will be healed.