魏子孝分期辨治痛风性关节炎经验浅析.docVIP

魏子孝分期辨治痛风性关节炎经验浅析 　　摘要：痛风性关节炎是临床常见的代谢异常引起的关节病变，中医药治疗具有疗效好、不良反应少等优势。魏子孝教授主张分期辨治。急性发作期属“湿热痹”，以清利湿热为法；间歇期以脾肾亏虚为主，以健脾补肾为法；慢性期基本病机为肝肾亏虚、痰瘀互结，治疗重在活血、化痰或补益肝肾。另外还主张参考现代中药药理研究成果，辨病用药，同时注意饮食生活调护 关键词：名医经验；魏子孝；痛风性关节炎；高尿酸血症；中医药疗法 DOI：10.3969/j.issn.1005-5304.2017.03.026 中图分类号：R271.91 文献标识码：A 文章编号：1005-5304（2017）03-0107-04 Discussion on Experience of Professor WEI Zi-xiao in Differential Treatment of Gouty Arthritis CHENG Xiang-wen1，2， ZHANG Guang-de3， Instructor： WEI Zi-xiao3 （1. Graduate School of China Academy of Chinese Medical Sciences， Beijing 100700， China； 2. Tianjin University of Traditional Chinese Medicine， Tianjin 300073， China； 3. Xiyuan Hospital， China Academy of Chinese Medical Sciences， Beijing 100091， China） Abstract： Gouty arthritis is a clinical common joint disease caused by metabolic disorder. TCM therapy has unique advantages， such as good efficacy and few adverse reactions. Professor WEI Zi-xiao advocates differential treatment for this disease. In his opinion， acute gouty arthritis is equivalent to TCM damp-heat arthralgia， and therapy of eliminating dampness and heat should be used. During the intermission， therapy of reinforcing spleen and nourishing kidney is appropriate because of deficiency of them. Deficiency of liver and kidney and phlegm and blood stasis are basic pathogenesis in chronic phase of the disease， therefore， activating blood， reducing phlegm and nourishing liver and kidney should be adopted. In addition， Professor WEI pays attention to pharmacological research achievement of TCM， disease differentiation and life and diet regulating in treatment of the disease. Key words： experience of famous TCM doctors； WEI Zi-xiao； gouty arthritis； hyperuricemia； TCM therapy 高尿酸血?Y是机体嘌呤代谢障碍和/或尿酸排泄减少引起血尿酸升高的一种疾病，当尿酸盐在体内沉积出现相应的临床表现时称为痛风，包括急慢性关节炎、痛风石、痛风性肾病等。流行病学调查显示，我国高尿酸血症患病率逐年升高，尤其经济发达地区高达5.0%～23.5%，并呈年轻化趋势[1]。急性痛风性关节炎是痛风的特征性表现，疼痛剧烈，目前西医治疗主要有非甾体类抗炎药、糖皮质激素、秋水仙碱等，但均存在明显不良反应，临床应用受到限制。慢性关节炎可引起关节僵硬、肿胀、变形，影响生活质量，西医对此尚无有效治疗办法。中医辨证论治对痛风性关节炎