| 王玉洁,周静威.周静威教授从伏邪论治类风湿关节炎经验撷萃[J].浙江中医药大学学报,2022,46(1):60-64. |
| 周静威教授从伏邪论治类风湿关节炎经验撷萃 |
| Professor ZHOU Jingwei‘s Experience in Treating Rheumatoid Arthritis from Incubative Pathogens |
| DOI：10.16466/j.issn1005-5509.2022.01.009 |
| 中文关键词: 类风湿关节炎 伏邪 透邪通痹 龙藤汤 医案 中医治疗 名医经验 周静威 |
| 英文关键词: rheumatoid arthritis incubative pathogens penetrating evil and removing arthralgia Longteng Decoction medical cases TCM treatment clinical experience of famous TCM experts ZHOU Jingwei |
| 基金项目:国家自然科学基金项目(81874401) |
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| 摘要点击次数: 1973 |
| 全文下载次数: 766 |
| 中文摘要: |
| [目的] 介绍与总结周静威教授从伏邪论治类风湿关节炎(rheumatoid arthritis，RA)的经验。[方法] 通过跟随周教授门诊抄方，对东直门医院肾病风湿免疫科RA患者初诊和后期随访的诊疗情况进行收集、整理和分析，查阅中医典籍和现代RA临床研究相关文献，从病因病机、临床诊疗思路及立法处方用药几个方面总结周教授从伏邪论治RA的经验，并举一则验案进行例证。[结果] 周教授认为伏邪是RA的始动因素，伏邪痹阻是RA的核心病机，由此立透邪通痹之法，采用大量藤类药，以通经入络，荡涤肌肉、筋骨等伏藏之邪气，改善RA患者关节肿胀、滑膜炎、关节破坏等病变，减少RA发作，延缓病情进展。周教授还注重RA的个体化治疗，主张“主症定病名，兼症定证型”，对基础方龙藤汤，进行随症加减，并结合四时养护、饮食、运动、定期随访等对患者进行综合管理，体现了中医整体观念、辨证论治的治疗原则。所举医案，患者辨为风湿热痹证，周教授治以透邪通痹、清热利湿、舒筋活络，并据此遣方用药，疗效显著。[结论] 周教授从伏邪论治RA，以透邪通痹为治则，龙藤汤为基础方，并根据患者不同情况进行加减，往往能收到较好的临床效果。周教授的经验丰富了中医药治疗RA的辨证论治体系，值得学习和推广。 |
| 英文摘要: |
| [Objective] To introduce and summarize Professor ZHOU Jingwei‘s experience in the treatment of rheumatoid arthritis(RA) from the theory of Fuxie(incubative pathogens). [Methods] By following Professor ZHOU‘s outpatient prescription， collecting， sorting and analyzing the initial diagnosis and subsequent follow-up diagnosis and treatment of RA patients in the Department of Nephrology， Rheumatology and Immunology of Dongzhimen Hospital， combined with consulting the ancient books of traditional Chinese medicine(TCM) and the relevant literature of modern RA clinical research， this paper summarized Professor ZHOU‘s experience in treating RA from incubative pathogens from etiology and pathogenesis， clinical diagnosis and treatment ideas and prescription medication， and took a case as an example. [Results] Professor ZHOU believes that incubative pathogens are the initiating factor of RA， and incubative pathogens arthralgia is the core pathogenesis of RA. The method of penetrating evil and removing arthralgia is established and large amount of rattan drugs are used to dredge the meridians and collaterals， clean up the hidden evil Qi in muscles and bones， improve the joint swelling， synovitis and joint destruction of RA patients， reduce the onset of RA and delay the progress of the disease. Professor ZHOU also pays attention to the individualized treatment of RA and advocates “determining the name of the disease with the main symptoms and the type of syndrome with concurrent symptom”. In clinic， he adds and subtracts the basic Longteng Decoction according to the symptoms， and comprehensively manages the patients in combination with four seasons maintenance， diet， exercise， regular follow-up and other ways， reflecting the overall concept of TCM and the treatment principle of syndrome differentiation and treatment. The patient cited in the medical record was differentiated as of wind-damp and heat arthralgia obstruction syndrome. Professor ZHOU treated him with penetrating evil and relieving arthralgia， clearing away heat and dampness， relaxing muscles and activating collaterals， and used prescription accordingly， finally he achieved remarkable curative effect. [Conclusion] Professor ZHOU treats RA according to the theory of incubative pathogens， takes penetrating evil and removing arthralgia as the treatment principle， takes Longteng Decoction as the basic formula， and adds or subtracts according to different conditions of patients， which can often receive better clinical effects. Professor ZHOU‘s experience enriches the syndrome differentiation and treatment system of TCM in the treatment of RA， and is worthy of learning and promotion. |
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