基于“随其所得”理论探讨系统性红斑狼疮的中医证治

Discussion on TCM Syndrome Differentiation and Treatment of Systemic Lupus Erythematosus Based on Theory of “Proper Treatment According to Disease Development”

“随其所得”理论源自《金匮要略》,是中医“治病求本”思想的重要延伸及发挥。该文基于“随其所得”理论,结合系统性红斑狼疮的现代医学研究,探讨该理论在系统性红斑狼疮中医诊治中的指导意义。认为系统性红斑狼疮临床表现虽然存在较大异质性,但基本病机总不离肝肾精血亏虚,热毒、瘀血等实邪为患,且常可因激素的使用造成证候特殊改变。治疗时将疾病分期和激素治疗阶段作为辨证分型的依据,同时不忘顺应脏腑生理特性用药,从而最大程度激发脏气,改善疾病预后。

The theory of“proper treatment according to disease development”originates from Synopsis of the Golden Chamber,which is an important extension and development of the thought of“treating diseases and seeking the root”in TCM.This article is based on the theory of“proper treatment according to disease development”,combined with the modern medical research of systemic lupus erythematosus,it explored the guiding significance of this theory in the diagnosis and treatment of systemic lupus erythematosus in TCM.It is considered that although the clinical manifestations of systemic lupus erythematosus have great heterogeneity,the basic pathogenesis is always related to the deficiency of liver,kidney,essence and blood,as well as heat toxin,blood stasis and other evils.In addition,the use of hormones can often cause special changes in syndromes.During the treatment,the disease stage and hormone treatment stage can be taken as the basis for syndrome differentiation and typing.At the same time,the treatment should follow the physiological characteristics of Zang-Fu organs when using medication,in order to maximize the Qi stimulation of Zang ograns and improve the prognosis.