基于“痰湿入营,伏邪致病”探讨痛风的诊疗思路

Discussion on diagnosis and treatment thoughts of gout based on‘phlegm dampness into nutrient and latent pathogens leading to disease’

文章运用“伏邪”理论,提出“痰湿入营,伏邪致病”的观点,从免疫炎症机制看伏邪致病在痛风中的作用机制,并结合六经对痛风不同分期的诊疗思路进行了探讨。阐明痛风的疾病全程特征,多与中医伏邪致病的病机相合。在张仲景六经理论指导下选取柴妙饮、侯氏黑散、百合地黄汤等作为基本方,根据痛风不同阶段的特点,分别从少阳湿热、太阴少阳同病和少阴阴虚3个角度临证加减,以期为中医诊治痛风提供新思路。

Based on the theory of‘latent pathogens’,the viewpoint of‘phlegm into in nutrient and latent pathogens leading to disease’was proposed,this paper discussed the mechanism of latent pathogens in gout from the mechanism of immune inflammation and discussed the diagnosis and treatment of different stages of gout combined with six channel.It also clarify the whole process characteristics of gout disease,which is consistent with the pathogenesis of traditional Chinese medicine.Under the guidance of ZHANG Zhongjing’s six channel theory,Chaimiao Decoction,HOUs’Black Powder and Baihe Dihuang Decoction were selected as the basic prescriptions.According to the characteristics of gout in different stages,this prescriptions were added or reduced from three perspectives,Shaoyang and dampness heat,Taiyin and Shaoyang same disease,Shaoyin and yin deficiency,in order to provide new treatment ideas for gout.