王耀光教授治疗痛风性关节炎临床经验总结

Summary of Professor WANG Yaoguang's clinical experience in treating gouty arthritis

关键词:  痛风性关节炎  浊毒  热痹  中医药治疗  名医经验  王耀光

Key words:  gouty arthritis  turbid toxin  heat arthralgia  traditional Chinese medicine treatment  famous doctor experience  WANG Yaoguang

摘要:

文章从病因病机、临床治疗调护等多方面总结王耀光教授治疗痛风性关节炎经验。王耀光教授指出痛风性关节炎临床分为急性期和缓解期，其病性为本虚标实之证，急性期以标实为主，辨证当属“热痹”范畴，多由湿热、痰浊、瘀血合而流注肢体关节为病。缓解期以本虚为主，多属脾肾亏虚，兼夹瘀毒之证，但究其致病之根应属于“浊毒”，故泄浊解毒之法应贯穿治疗始终，急性期以清热解毒、利湿止痛为主，以桂枝芍药知母汤为主方加减，并根据患者病性偏胜的不同，加用化痰泄浊或活血化瘀之品，又根据中医取类比象之法，于处方中加入祛风通络之青风藤、海风藤、忍冬藤等藤类药物，取其伸筋通络止痛之功，并内外合治应用痛风止痛方外洗缓解患者症状；缓解期以补脾益肾，化瘀解毒为主，以玉屏风加味合宣痹降浊方治疗，反复发作者加用“虫蚁搜剔”之法，配合间断饮用土茯苓水巩固善后，临床疗效显著。

Abstract:

This article summarized Professor WANG Yaoguang's experience of gouty arthritis treatment from the viewpoint of etiology, pathogenesis, clinical treatment and nursing. The nature of gouty arthritis is a deficiency in origin and excess in superficiality. Professor WANG Yaoguang pointed out that gouty arthritis can be divided into an acute phase and a remission phase. In the acute phase, the syndrome is mainly based on inflammation, which is caused by damp heat, turbid phlegm, and blood stasis infuse of limbs and joints. As for the remission phase, the syndrome is primarily caused by a deficiency of the spleen and kidney. The "turbid toxin" was recognized as the root of pathology and the main treatment should target by draining turbidity and detoxification. In the treatment of the acute phase, Guizhi Shaoyao Zhimu Decoction was employed as the main prescription to relieve dampness and relieve pain. Based on the patient's condition, an additional synergy prescription can be used to promoting blood circulation, removing phlegm, and turbidity. In the meantime, the combined treatment with gout and pain relief prescriptions to relieve the symptoms of patients can be achieved. According to the method of analogy in traditional Chinese medicine, adding rattan botanical in the prescription are expected for tendons stretch and pain relief. The treatment of the remission phase should primarily be focused on invigorating the spleen, kidney, detoxification, and blood stasis removal. The remarkable result was treated by the combination of Yupingfeng Powder with Xuanbi Jiangzhuo Decoction for treatment. Patients who were found with a recurrent condition should use insect medicine served with intermittent of Tuckahoe water as the strengthen prescription.