银屑病关节炎中西医治疗研究进展

A review on the treatment of psoriatic arthritis in traditional Chinese medicine and Western medicine

银屑病关节炎(Psoriatic Arthritis,PsA)是一种以累及脊柱和/或外周关节为主的银屑病相关的慢性进展性炎性关节炎。本病发病机制复杂,涉及遗传、环境、免疫等多种因素。患者的临床表现复杂多样,除具有典型的银屑样皮疹外,还可以出现外周及中轴关节炎、指趾炎等附着点炎症状,严重影响患者的生活质量。目前治疗常用药物包括非甾体抗炎药、抗风湿药及生物制剂,主要以缓解症状为目标,但存在不良反应多、停药后病情易复发、价格昂贵等缺点。同时由于本病异质性强,也为临床诊治带来了一定困难。中医药历史悠久,具有简、便、廉、效的优点,强调辨证论治,个体化治疗,通过内服、外用综合疗法,可以多途径、多靶点作用于疾病,对PsA显示出很好的疗效。近年来,中西医结合治疗PsA的临床研究也越来越多,其在提高临床疗效的同时还减少了不良反应的发生,值得推广使用。文章将结合近几年相关研究,从中西医不同角度探讨PsA的病因病机及发病机制研究进展,分析总结各大医家对本病的认识及中医治法和用药规律,探讨其疗效,并对内服和外治法进行综述,体现中医治疗PsA的优势,以期为PsA的临床治疗提供更多思考和方法。

Psoriatic arthritis is a chronic progressive inflammatory arthritis associated with psoriasis that predominantly affects the spine and/or peripheral joints.The pathogenesis of this disease is complex,involving genetic,environmental,immune and other factors.The clinical manifestations of patients are complex and diverse,in addition to typical psoriasis rash,peripheral and axial arthritis,dactylitis and other enthesitis symptoms can occur,which seriously affects the quality of life of patients.At present,commonly used drugs for treatment include non-steroidal anti-inflammatory drugs,antirheumatic drugs and biological agents,mainly aiming at relieving symptoms,but there are many adverse reactions,easy to recur after stopping the drug,expensive and other disadvantages.At the same time,due to the strong heterogeneity of the disease,it also brings certain difficulties to the treatment.Traditional Chinese medicine has a long history,with the advantages of simplicity,convenience,low price and effectiveness,emphasizing differential treatment,individualized treatment,through internal and external comprehensive therapy,can act on diseases in multiple ways and targets,showing good efficacy on psoriatic arthritis.In recent years,there have been more and more clinical studies on the treatment of psoriatic arthritis by combining traditional Chinese medicine and Western medicine,which improves clinical efficacy and reduces the occurrence of adverse reactions,and is worth promoting and using.The article will combine relevant research in recent years to discuss the research progress of the etiology,pathogenesis and pathogenesis of psoriatic arthritis from different perspectives of traditional Chinese medicine and Western medicine,and analyze and summarize the understanding of the disease and the treatment methods and medication rules of traditional Chinese medicine by major doctors,and explore its efficacy.This paper reviews the internal and external treatment methods,reflecting the advantages of traditional Chinese medicine in the treatment of psoriatic arthritis,in order to provide more thinking and methods for the clinical treatment of psoriatic arthritis.