基于“亢害承制”理论探讨类风湿关节炎的发病机制及中药治疗研究进展

Pathogenesis and Traditional Chinese Medicine Treatment of Rheumatoid Arthritis Based on Theory of"Harmful Hyperactivity and Responding Inhibition"

类风湿关节炎(RA)是一种慢性自身免疫性疾病,发病机制复杂。免疫功能紊乱、滑膜炎症及骨破坏是其关键的病理环节。“亢害承制”理论是对自然界中事物协调发展、五运六气生克制化的高度总结。人与万物同源,“亢害承制”亦体现了人体稳态的内在调节机制,阐明“亢”与“制”的对立统一,强调协调与稳定。在RA的发病过程中,过度的免疫反应破坏了正常的机体平衡,这与“承者失制”密切相关。滑膜炎症及组织增生和骨的破坏是机体免疫自稳功能失调导致的病理结果,均可以被视为“亢者为害”。因此,“亢害承制”理论为理解RA的现代病理机制提供独特的视角。笔者基于“亢害承制”理论,结合RA的发病机制,从中医的角度解析RA的现代医学基础,揭示气血不足、卫强营弱、痰瘀互结等中医病机与自身免疫紊乱、滑膜炎症与增生、骨破坏等现代研究之间的内在联系。此外,该文以“扶制抑害”为治疗准则,总结了中药治疗RA“平亢扶制”的作用机制,为RA的临床治疗提供理论参考。

Rheumatoid arthritis(RA)is a chronic autoimmune disease with a complex pathogenesis.Immune dysfunction,synovial inflammation,and bone destruction are the key pathological links.The theory of"harmful hyperactivity and responding inhibition"is a high-level summary of the coordinated development of things in nature and the generation and restriction of the five elements and the six factors in nature.People and all things have the same origin,and the theory of"harmful hyperactivity and responding inhibition"represents the intrinsic regulation mechanism of the human body's homeostasis,reflecting the unity of opposites of"hyperactivity"and"inhibition"and emphasizing coordination and stabilization.In the pathogenesis of RA,the excessive immune response disrupts the normal body balance,which is closely related to the process of"hyperactivity becoming harmful".Synovial inflammation,tissue hyperplasia,and bone destruction are pathological results of the dysregulation of the body's immune self-stabilization function and can be regarded as the process of"failing to inhibition".Therefore,the theory of"hyperactivity harmful hyperactivity and responding inhibition"provides a unique perspective for understanding the modern pathological mechanisms of RA.Based on the theory of"harmful hyperactivity and responding inhibition"and the pathogenesis of RA,the author analyzed the modern medical basis of RA from the perspective of traditional Chinese medicine(TCM)and revealed the intrinsic connection between TCM pathogenesis such as insufficiency of vital energy and blood,strong defensive Qi and weak nutrient Qi,and intertwined phlegm and blood stasis and modern research on autoimmune disorders,synovial inflammation,and bone destruction.With the therapeutic criterion of"harm inhibition and responsible supporting",the article summarized the mechanism of TCM in calming hyperactivity and supporting invincibility,which provided theoretical references for the clinical treatment of RA.