马小军从浊邪辨治痛风性关节炎

Chief phisician MA Xiaojun’s experience in treating gouty arthritis from the perspective of turbid pathogen

痛风是嘌呤代谢紊乱和(或)尿酸排泄减少所引起的一种晶体性关节炎,临床表现为高尿酸血症和尿酸盐结晶沉积于四肢各关节。痛风性关节炎患者症状表现为受累关节出现明显的红、肿、热、痛和功能障碍。关节里的尿酸结晶会导致关节发炎,进而引起剧痛,有的患者甚至需要服用止痛片镇痛,严重影响患者生活质量。甘肃省天水市中医医院马小军主任医师认为,脾肾亏虚是痛风发生的内在基础,浊邪是发病的关键,浊邪窃居体内,反复作祟伤及脏腑经络,导致经脉痹阻不通,发生痛风。浊邪作为发病的关键,祛除浊邪应贯穿疾病发展的始终。采取祛浊通络、补脾益肾、急性期加用外敷法,在对痛风性关节炎症状的缓解和减少复发等方面均有较好的临床疗效。他把痛风分为急性发作期和慢性缓解期,以祛除浊邪为根本治疗原则,在临床中取得较好疗效。文章结合案例介绍马小军主任治疗痛风性关节炎的经验,以期为临床提供参考。

Gout is a kind of crystalline arthritis caused by disordered purine metabolism and/or reduced excretion of uric acid,clinically characterized by hyperuricemia and urate crystals deposition in the joints of the limbs.Symptoms in patients with gouty arthritis include significant redness,swelling,heat,pain,and dysfunction in the affected joints.The crystallization of uric acid in the joints can cause joint inflammation,and then cause severe pain.Some patients even need to take painkillers to relieve pain,which seriously affects the quality of life of the patients.Chief physician MA Xiaojun believes that spleen and kidney deficiency is the internal basis of gout,and the turbid pathogen is the key to the onset of the disease.Zang-fu(脏腑)and meridians and collaterals are injured by turbid pathogenic factors,and the meridians are obstructed,eventually gout occurs.Turbid pathogen as the key to the disease,turbid pathogenic factors should be eliminated in the whole treatment process.The methods of dispelling turbidity and dredging collaterals,tonifying the spleen and tonifying the kidney,and external application in the acute stage have good clinical effects in relieving symptoms and reducing recurrence of gouty arthritis.He divided gout into acute attack period and chronic remission period,and took removing turbid pathogen as the fundamental treatment principle,which achieved good curative effects in clinical practice.In this paper,Director MA Xiaojun’s experience in treating gout arthritis is introduced through a case analysis,in order to provide clinical references.