李彦民治疗类风湿关节炎经验

类风湿关节炎(RA)在中医学中属于“痹病”范畴，是临床中常见的难治性疾病，且呈年轻化趋势，迁延难愈。目前现代医学对RA的发病病因及机制尚不完全清楚。《素问·痹论》提出风寒湿三邪致痹，还有学者提出痰瘀致痹、肝肾亏虚等观点。李彦民主任医师根据多年临床经验提出RA的病机关键是络脉痹阻，其病机特点是虚实夹杂，临床辨证分为寒湿阻络型、湿热蕴结型、痰瘀互结型、气血两虚型、肝肾亏虚型等五型。分别采用祛邪通络和补虚通络等不同治则，辨证施法。李老师善用川乌、鸡血藤以及乌梢蛇等药以通络止痛，并主张辨证用药，内外兼治，多取良效。临床采用经验方仙龙汤，配合外用舒筋活络洗剂，且取得理想疗效。

Li Yanmin's experience in treating rheumatoid arthritis

Rheumatoid arthritis(RA)belongs to the category of “paralysis” in Chinese medicine,and it is a common clinical disease with a tendency to be younger and more difficult to be cured,the control of this disease is extremely important.The etiology and mechanisms of RA pathogenesis are currently unknown in western medicine.In the Suwen·Bilun propose that the three evils of wind,cold and damp cause paralysis,some scholars put forward the viewpoint that phlegm and blood stasis cause arthralgia and deficiency of liver and kidney.Based on years of clinical experience,Dr.LI,believes that the key to the pathogenesis of rheumatoid arthritis is paralysis of the ligaments and veins.The disease mechanism is characterized by a mixture of deficiency and realit.The clinical evidence is divided into five types:cold-damp blocking type,damp-heat accumulation type,phlegm-stasis interconnection type,qi-blood deficiency type,liver-kidney deficiency type,etc.Dr.LI makes good use of rhizomes such as acontit radix and millettia dielsiana,as well as insects such as zaocys,in order to promote the circulation and relieve pain.And advocate dialectical medicine,both internal and external treatment,and many good results.The clinical use of the empirical formula Xianlong decoction,together with the topical application of Shujin Huoluo decoction,and has achieved satisfactory results.