从“三焦气机”探讨痛风的辨治思路

Discussion on the idea of recognizing and treating gout from‘triple energizer qi transformation'

文章通过对痛风发病机制及三焦结构与功能的探析,认为痛风病位在于三焦,其发病机制责之三焦气机不利,提出痛风病机以湿热流注三焦为痹、三焦气机不利为本、元阳不助三焦为变。在治疗上应以通达三焦气机贯穿始终,并根据痛风的不同病程特点及三焦气机不利程度,分期论治。急性期开鬼门,方选越婢汤;缓解期洁净府,选用五苓散、桂苓甘露饮;慢性期温元阳,以桂枝芍药知母汤加减治疗。

By analyzing the pathogenesis of gout and the structure and function of the triple energizer,it is believed that gout lies in the triple energizer and its pathogenesis is attributed to unfavorable triple energizer qi,and it is proposed that gout is paralyzed by the flow of dampness-heat into the triple energizer,unfavorable triple energizer qi,and Yuan-Yang does not help the triple energizer.In the treatment,the San Jiao qi should be accessed throughout the whole process,and according to the different characteristics of gout and the degree of unfavorable San Jiao qi,the treatment should be staged.To open the ghost gate in acute stage,the formula is Yue Bi Decoction;to cleanse the capital in relieving stage,Wu Ling Powder and Guilin Ganluo Decoction are used;to warm the Yuan-Yang in chronic stage,Guizhi Shaoyao Zhimu Decoction is used to treat the disease with addition and subtraction.