类风湿关节炎的骨病变从络病论治

背景:历代医家虽对类风湿关节炎骨病变有着丰富的论述,但鲜有从络病体系探讨者。目的:从药物治疗分类、病因分析以及"络息成积"以及等几个方面进行总结报道。方法:检索中国知网、EI、SCI、ISTP数据库1900年至今的相关文献;英文检索词为"The bone erosion of Rheumatoid arthritis,TCM collaterals theory"。选取其中内外共十余篇资料从药物治疗分类、病因分析以及"络息成积"等几个方面展开分析。结果与结论:(1)类风湿关节炎骨病变诱因之一为中医之络病,内伤顽固性疾病的发展要遵从由经及络、由气入血、由功能性病变到器质性损伤的疾病发展规律;(2)类风湿关节炎骨病变之病机在于"络息成积",认为是痰聚蕴瘀,瘀存助痰,瘀积痰淫,坏血肿肉,腐骨蚀筋而使关节肿胀、畸形,甚至破坏的过程;(3)类风湿关节炎骨病变治疗之"络以通为用",目的是为了能够保证络脉的通畅,从而让脏器和气血运行正常,从而实现血管通畅,缓解类风湿关节炎病症。

Treatment of rheumatoid arthritis based on the collateral disease theory

BACKGROUND:Although ancient physicians had rich discussions on rheumatoid arthritis,few have discussed based on the theory of collaterals diseases.OBJECTIVE:To summarize the drug treatment classification,etiology analysis,and "collateral-interest accumulation." METHODS:CNKI,El,SCI,and ISTP databases were searched for articles published after 1900.The keywords were "The bone erosion of rheumatoid arthritis,TCM collaterals theory." Data from more than 10 domestic and foreign articles were selected to analyze the drug treatment classification,etiology analysis,and "collateral-interest accumulation." RESULTS AND CONCLUSION:(1) One of the causes of rheumatoid arthritis bone disease is the collaterals disease of traditional Chinese medicine.The development of intractable diseases should follow the law of the development of diseases from the meridians to the collaterals,from the gas to the blood,and from the functional lesions to the organic diseases.(2) The pathogenesis of rheumatoid arthritis lies in the accumulation of collaterals,which causes joint swelling,joint deformity and damage.(3) The treatment of "collaterals for the use of circulation" for rheumatoid arthritis is to keep the collaterals,organs and blood-gas in fluent,thus ensuring the fluent circulation to alleviate the symptoms of rheumatoid arthritis.