类风湿性关节炎从脾论治探讨

Research on the Treatment of Rheumatoid Arthritis Based on Spleen

类风湿性关节炎 (RA)的中医学病机为脾胃虚弱、湿浊内生 ;气血不足 ,营卫失调 ;痰瘀互结 ,脉络阻滞。中医证候呈现脾虚湿盛、虚实夹杂的特征。中医治法为健脾益胃 ,调补后天 ;扶助正气 ,益气养血 ;急则治标 ,祛痰化湿。RA从脾论治取得满意的临床疗效 ,其机制为免疫抗炎 ,维持免疫功能平衡 ;调节细胞因子 ,降低血管通透性 ;恢复滑膜、胸腺有序的细胞凋亡 ;

The pathologic mechanism of rheumatoid arthritis(RA) in traditional Chinese medicine(TCM) was deficiency of the spleen and stomach, stagnancy of pathogenic damp, Qi blood deficiency, disharmony between nutritive Qi and defensive Qi, accumulation of phlegm and stasis, block of channels and collaterals. TCM semeiology character of RA was retention of water due to hypofunction of the spleen, deficiency complicated by excess symptoms. The therapeutic method of RA in TCM was protecting spleen and stomach, reinforcing acquired constitution; supporting vital Qi, tonifying Qi blood; dispelling phlegm and resolving dampness, relieving the secondary in an urgent case. Clinical treatment result of RA based on spleen was good. The effective mechanism is related to the following factors: anti inflammation, keeping the blance of immune function, adjusting cytokines,reducing the permeability of blood vessel, recovering the orderly apoptosis of synoviocytes and thymuslymphocytes,protecting gastric mucosa.