从肝、肾、督角度探讨强直性脊柱炎分期治疗思路

Discussion on staging treatment of ankylosing spondylitis from the angle of liver,kidney and governor

作者通过多年跟随甘肃省名中医王海东教授临证学习及结合历代医家对强直性脊柱炎(AS)的认识,认为此病病变特点与肝、肾、督有一定的关系,并在文中阐述肝肾精亏、督肾虚寒在AS发病中的重要性。认为AS病机关键为先天肝肾精血亏虚、督肾阳气不足,复因感受风、寒、湿、热之邪气,化痰、化瘀、化毒,侵犯腰骶经脉而致病。治疗上稳定期以补益肝肾、温阳通督为主,方选《武威汉代医简》五劳七损方加减;活动期以寒热为纲,辨证为肾虚督寒型、肾虚湿热型,肾虚督寒型选用寒痹颗粒加减,肾虚湿热型选用热痹颗粒加减;中晚期以活血化痰通络为要,并配合小针刀治疗以改善患者功能活动,方选双合汤加减,临证疗效显著。

After years of studying with the famous doctor Wang Haidong of gansu Province,the author learned about the disease and combined with the knowledge of ancient physicians on this disease.He believes that the characteristics of ankylosing spondylitis(AS)have a certain relationship with the liver,kidney,and governor,and elaborates the liver and kidney in the text.The importance of sperm deficiency and kidney deficiency in the pathogenesis of AS.The key to the pathogenesis of AS is congenital hepatorenal blood deficiency and deficiency of yang yang.Due to the feelings of wind,cold,dampness,and heat,the phlegm,phlegm,stasis,poisoning,and morbidity caused by invading the meridians of the lumbosacral.In the stable period of treatment,liver and kidney are supplemented,and Wenyang is instructed as the governor.The selected"Wuwei Han Dynasty Medical Jian"has five labor and seven loss prescriptions;the active period is cold and heat as the key,syndrome differentiation is kidney-deficiency-diagnosis-type,kidneyheat-dampness and heat-type,kidney-deficiency disease.Cold type chilling granules addition and subtraction,kidney heat damp type heat glutinous granules addition and subtraction;middle and late to blood circulation phlegm and collaterals,and with a small needle knife treatment to improve the patient's functional activities,side election double combination decoction,Pro Significant effect.