主 办:北 京 中 医 药 大 学
ISSN 2095-6606 CN 10-1157/R

现代中医临床 ›› 2020, Vol. 27 ›› Issue (4): 36-38.doi: 10.3969/j.issn.2095-6606.2020.04.008

• 名老中医经验 • 上一篇    下一篇

王大经主任医师分期论治类风湿关节炎经验*

李屏, 马丛, 温博, 张秦, 路素言, 王北#   

  1. 首都医科大学附属北京中医医院风湿病科 北京 100010
  • 发布日期:2020-07-30
  • 通讯作者: #王北,女,主任医师
  • 作者简介:李屏,女,主治医师
  • 基金资助:
    *北京中医药“薪火传承3+3工程”室站建设项目(No.2014-SZ-A-30),北京市中医管理局燕京流派创新性传承“拳头”工程

Chief physician Wang Dajing's experience with stage-based treatment of rheumatoid arthritis*

Li Ping, Ma Cong, Wen Bo, Zhang Qin, Lu Suyan, Wang Bei#   

  1. Department of Rheumatology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010
  • Published:2020-07-30

摘要: 类风湿关节炎是一种以慢性、侵蚀性多关节炎为主要表现的自身免疫病,病理表现为滑膜炎、血管翳形成和血管炎。王大经主任医师对类风湿关节炎的中医诊治有独到见解。他认为类风湿关节炎的病机核心为“毒”邪致病。他参考化验结果,进行中医分期辨证,将发作期分为偏热证、偏寒证、寒热夹杂证。偏热证治疗以清热解毒、祛瘀通络为法,方以风引汤化裁;偏寒证治疗以温经逐寒、活血通络为法,方以阳和汤加附子化裁;寒热夹杂证治疗以寒热并用、解毒散寒为法,方以阳和汤合仙方活命饮加减。将稳定期归为气血亏虚、痰瘀互阻证,治疗以益气养血固本为主,辅以通络解毒、通利关节,取丸剂缓图。他强调寒热辨证及功能锻炼,取得了较好的临床效果。

关键词: 类风湿关节炎, 辨证论治, 名医经验, 王大经

Abstract: Rheumatoid arthritis is a systemic autoimmune disease characterized by chronic erosive polyarthritis. Its pathological manifestations are synovitis, formation of pannus, and vasculitis. Chief physician Wang Dajing has unique insights into the diagnosis and treatment of rheumatoid arthritis in traditional Chinese medicine(TCM). He believes that the core pathogenesis of rheumatoid arthritis is “toxin” resulting in this disease. With reference to the lab test results, he carried out stage-based TCM syndrome differentiation. The attack stage can be divided into partial heat syndrome, partial cold syndrome and cold-heat mixed syndrome. As the treatment of partial heat syndrome, clearing heat, removing blood stasis and dredging collaterals are the treatment method and recommended formula is Fengyin Dang; as for the treatment of partial cold syndrome, warming the meridians, expelling cold and promoting blood circulation to remove meridian obstruction are the treatment methods, and recommended formula is Yanghe Dang plus Fuzi; as for treatment of mixed cold and heat syndrome, the treatment method is the simulateous use of cold and heat, detoxifing and expelling cold, and recommended formulas are Yanghe Tang in combination with modified Xianfanghuoming Yin. The stable period is classified as the syndrome of qi and blood deficiency and mutual obstruction of phlegm and blood stasis, which is mainly treated by tonifying qi, nourishing blood and solidifying the foundation, supplemented by dredging collaterals and detoxification, dredging joints, and taking pills. He emphasizes syndrome differentiation of cold and heat and functional exercise, with good clinical efficacy.

Key words: rheumatoid arthritis, treatment based on syndrome differentiation, famous doctor's experience, Wang Dajing

中图分类号: 

  • R255.6