基于“正气存内,邪不可干”论补肾强督法治疗强直性脊柱炎

Treating ankylosing spondylitis by invigorating kidneys and strengthening the governor vessel based on the theory of“Evil pathogen will not disturb if healthy Qi exists in the body”

强直性脊柱炎(Ankylosing Spondylitis,AS)是一种慢性炎症性疾病,属于风湿免疫病。中医学将其纳入“痹证”“腰痛”等范畴,认为AS的发病以肾虚为本,督脉失养,标实多因而致。“正气存内,邪不可干”是出自《素问•刺法论篇》的中医经典理论。文章详细阐述了“正气存内,邪不可干”理论之内涵,意从正气不足,外邪入侵的角度探讨AS的病因病机以及治疗现状,“正气”不足,则“邪气”易袭,致疾病发生,在该理论的指导下,认为AS的治疗方法当扶正以祛邪,通过扶正气、补肾脏、强督脉的方法达到祛邪气之用,进一步证实了治疗AS当用补肾强督法,该法不仅在疾病发生阶段取得显著的临床疗效,更能在疾病发展后期稳定病情,较大程度减少了疾病发生,因此,应以补肾强督之疗法贯穿该疾病的治疗始终。以“正气存内,邪不可干”为临床诊疗思路,主要从治疗原则及方法、临床运用、调养及预后等方面进行了详细阐述,总结临床治疗AS更需强调补肾、温肾原则,以达到“正气存内,邪不可干”的效果,以期为今后中医药治疗AS提供参考价值,更好地指导临床实践。

Ankylosing spondylitis is a chronic inflammatory disease,which belongs to the rheumatic immune disease.Traditional Chinese medicine holds that ankylosing spondylitis is in the category of“paralysis”and“lumbago”,and believes that the onset of ankylosing spondylitis is caused by deficiency of the kidneys,a loss of nourishment of the governor vessel,and shows many symptoms.“Evil pathogen will not disturb if healthy Qi(气)exists in the body”is a classic theory of traditional Chinese medicine recorded in Suwen(《素问》).The paper elaborates the connotation of the theory of“Evil pathogen will not disturb if healthy Qi exists in the body”,which means to discuss the etiology,pathogenesis and treatment status of ankylosing spondylitis from the perspectives of the lack of healthy Qi and invasion of external evil pathogen.Under the guidance of this theory,it is believed that the treatment method of ankylosing spondylitis should be to strengthen the healthy Qi and to dispel external evil pathogen,and the method of reinforcing the healthy Qi,tonifying the kidney and strengthening the governor vessel can be used to dispel evil pathogen,which further confirms that the treatment of ankylosing spondylitis should be tonifying kidneys and strengthening the governor vessel.The therapy of tonifying the kidneys and strengthening the governor vessel not only achieves significant clinical efficacy in the stage of disease development,but also in the later stage of disease development,and it can stabilize the condition of patients with ankylosing spondylitis,and reduce the occurrence of disease to a greater extent.Therefore,the therapy of tonifying the kidneys and strengthening the governor vessel should be used throughout the treatment of the disease.This paper takes“Evil pathogen will not disturb if healthy Qi exists in the body”as the clinical diagnosis and treatment idea,and elaborates mainly the treatment principles and methods,clinical application,recuperation and prognosis,and it summarizes that the clinical treatment of ankylosing spondylitis needs to emphasize the principle of tonifying kidney and warming kidney,in order to achieve the effect of“Evil pathogen will not disturb if healthy Qi exists in the body”,in order to provide reference value for the future treatment of ankylosing spondylitis in traditional Chinese medicine and to better guide clinical practice.