从叶天士络瘀则胀思想论治痛风性关节炎

Differentiating and treating gouty arthritis based on Ye Tianshi's thought of"static collaterals leading to swelling"

痛风性关节炎属中医痹病、白虎历节病范畴,以络脉瘀痹为标,正气亏虚为本。叶天士“络瘀则胀”理论源自其络病学说,应用在治疗痛风性关节炎中,络瘀指络脉不通的状态,根据痛风性关节炎不同时期病邪特征,分为湿热、痰浊、瘀血阻塞经络,且病邪随疾病发展发生转化,初期以湿热阻络为主,后期发展至痰湿痹阻、痰瘀互结、瘀血痹阻。治疗上以通络除痹为原则,治有宣通清解法、辛药通络法及扶正通络法。

Gouty arthritis belongs to bi diseases or acute arthritis in traditional Chinese medicine,which is manifested as stagnant collaterals and characterized by its root cause of defi ciency of vital qi.The theory of"static collaterals leading to swelling"by Ye Tianshi originates from his theory of collateral diseases and is applied in the treatment of gouty arthritis.According to his theory,static collaterals refer to the state of blocked collaterals and the pathogenic factors in diff erent stages of gouty arthritis can be divided into damp-heat,phlegm-turbidity,static blood,which obstruct the collaterals and transform as the disease progresses.Its acute phase is mainly due to damp-heat obstructing the collaterals,while in its later stage,the disease develops to phlegm-dampness blockade,intermingled phlegm and blood stasis,and blood stasis obstruction.Its treatment principle involves dredging collaterals and eliminating obstructions by adopting the methods such as promoting and clearing the channels,unblocking the meridians with pungent herbs and strengthening vital qi to clear the collaterals.