类风湿关节炎痰湿证诊疗研究进展

Research progress in the diagnosis and treatment of rheumatoid arthritis with phlegm-dampness syndrome

痰湿证是类风湿关节炎(RA)常见证型,与脾失运化关系密切。结合现代医学对痰湿致病、脾失健运病机特点的认识,认为促进RA发展的重要因素包括与脂质代谢紊乱、糖调节异常、肠道菌群失调相关的炎症,饮食不节或外来因素导致糖脂代谢紊乱并影响肠道微生物群失调,引起肠黏膜屏障受损,产生的代谢产物促进内源性糖脂代谢失衡和炎症反应,进而形成RA痰湿证的生物学基础。健脾祛湿化痰治法可纠正机体糖脂代谢紊乱,还可通过改善RA患者肠道菌群组成而调整内源性糖脂代谢、抑制RA炎症,从而发挥治疗作用。

Phlegm-dampness syndrome is a common syndrome type of rheumatoid arthritis(RA),which is closely related to spleen dysfunction.Combined with the understanding of modern medicine on the pathogenesis of phlegm dampness and spleen dysfunction,it is believed that the important factors to promote the development of RA include inflammation related to lipid metabolism disorders,abnormal glucose regulation,and intestinal flora imbalance.Improper diet or external factors lead to glucose and lipid metabolism disorders and affect the imbalance of intestinal microbiota,causing damage to the intestinal mucosal barrier.The metabolites produced promote endogenous glucose and lipid metabolism imbalance and inflammatory response,thus forming the biological basis of RA with phlegm dampness syndrome.The method of invigorating spleen,removing dampness and resolving phlegm can correct the disorder of glucose and lipid metabolism in the body.It can also adjust endogenous glucose and lipid metabolism and inhibit RA inflammation by improving the composition of intestinal flora in RA patients,thus playing a therapeutic role.