基于“湿瘀伏热”理论探讨痛风合剂治疗痛风湿热瘀阻证

Discussion on Treatment of Gout of Dampness-heat and Blood Stasis Syndrome with Tongfeng Mixture Based on Theory of"Dampness Stasis and Latent Heat"

痛风是一种由于单钠尿酸盐沉积关节周围所致的晶体相关性关节病,主要临床表现为关节红肿热痛、活动受限,属于中医学中“历节、痹证”范畴。中医认为痛风的主要病理因素为痰湿、血瘀,且其发病符合“伏毒”的特点。本课题组在反复临床实践中积累了丰富经验,在“湿瘀”理论及“伏毒”理论的基础上,针对痛风提出“湿瘀伏热”理论,认为其为缓解期核心病机,“湿热瘀阻”为发作期核心病机,临证多以清热利湿、活血止痛为主要治法,并在四妙丸的基础上化裁痛风合剂,在痛风性关节炎湿热瘀阻证的治疗中取得较好的临床效果。

Gout is a kind of crystal-associated arthropathy caused by the deposition of monosodium urate around joint,the main clinical manifestations are joint pain,redness,swelling and limited movement,which is classified as"Lijie(multiple arthralgia)"and"Bizheng(arthralgia)"in traditional Chinese medicine.Traditional Chinese medicine believes that the main pathological factors of gout is phlegm dampness and blood stasis,and the pathogenesis of gout is in accordance with the characteristics of"latent toxin".Our research group has accumulated rich experience in repeated clinical practice,on the basis of the theory of"damp stasis"and"latent toxin",we put forward the theory of"dampness stasis and latent heat"for gout,and hold that it is the core pathogenesis of acute stage while dampness-heat and blood stasis is the core pathogenesis of remission stage.Most of the clinical syndromes are clearing heat and dampness,promoting blood circulation and relieving pain as the main treatment methods,and on the basis of Simiao Pills,Tongfeng Mixture is created,which has achieved good clinical curative effect in the treatment of gouty arthritis with dampness-heat and blood stasis syndrome.