王振亮运用四逆汤治疗成人斯蒂尔病经验

Professor Wang Zhenliang’s experience in treating adult-onset Still’s disease with Sini Tang

成人斯蒂尔病是一种多因素参与的自身炎症性疾病,以发热、皮疹、关节疼痛和多器官受累为特点,目前尚无根治办法。西医治疗以非甾体类抗炎药、糖皮质激素、免疫抑制剂及生物制剂治疗为主。王振亮教授认为阳虚寒凝血瘀是成人斯蒂尔病核心病机,临床表现以阴阳不和、寒凝血瘀为主,也常夹湿、郁热,病位在半表半里,病性寒热错杂,以温阳益气立法,以四逆汤为核心方,同时重视顾护脾胃以及治血药的运用,谨守病机随证配伍,灵活运用。

Adult-onset Still’s disease is a multifactorial autoinflammatory disease characterized by fever,rash,arthralgia and multiple organ involvement,and there is no cure at present.Western medicine treatment is mainly provided with nonsteroidal anti-inflammatory drugs,slow-acting anti-rheumatic drugs,glucocorticoids,and biological agents.Professor Wang Zhenliang believes that Yang deficiency,cold coagulation,and blood stasis are the core pathogenesis of adult-onset Still’s disease.The clinical manifestations are mainly disharmony between Yin and Yang,cold coagulation,and blood stasis,often accompanied by dampness and heat stagnation.The disease is located in half the surface and half the interior,with a mixed nature of cold and heat.The legislation is based on warming Yang and supplementing Qi,with Sini Tang as the core formula.At the same time,attention is paid to the use of spleen and stomach care,as well as blood treatment drugs.It is important to adhere to the compatibility of the pathogenesis with the syndrome and use it flexibly.