摘要
强直性脊柱炎(ankylosing spondylitis,AS)的病机为肾虚督亏、寒湿热痹阻、脉络瘀阻,为本虚标实之证。其病因以肾阳虚衰,外邪入侵和病理产物蓄积为主,内因为肾督阳虚,外因为寒、湿、热、风邪,病理产物主要包括痰浊、瘀血,外因中寒邪入侵尤为关键。故笔者临床治疗AS多从肾督辨治,从脾胃辨治,从痰浊、瘀血辨治,强调从肾督、脏腑、脾胃、血瘀等方面论治,临证中把本病分为肾虚督寒证、寒湿阻滞证、瘀血痹阻证、湿瘀互结证四型,根据不同的症状体征标本兼顾,应用固肾通督、温经散寒、祛风健脾除湿、化瘀通络等治疗方法,灵活用药。常用的药物有补虚药、祛风湿药、活血化瘀药、清热药及平肝熄风药。
The pathogenesis of ankylosing spondylitis(AS)is deficiency of kidney and governor vessel(GV),obstruction of cold dampness and heat,obstruction of meridians and blood stasis,which is the syndrome of root deficiency and branch excess.The main causes of the disease are kidney yang deficiency,invasion of external pathogens and accumulation of pathological products.The internal causes are kidney and GV yang deficiency,while external causes are cold,damp,heat and wind pathogens.The pathological products mainly include phlegm turbidity and blood stasis.Among the external causes the invasion of cold pathogens is the key.Therefore,according to many years'clinical practice,the author's treatment is mainly based on the differentiation and treatment of kidney and GV,the spleen and stomach,phlegm and blood stasis,etc.The disease includes four syndrome types:syndrome of kidney deficiency and governor vessel cold,syndrome of cold dampness blockage,syndrome of stagnation of blood stasis and obstruction,syndrome of stagnation of dampness and blood stasis.According to different symptoms and signs,the treatment methods of strengthening the kidney and dredging GV,warming the meridians and dispersing the cold,eliminating wind and invigorating the spleen and removing dampness,removing blood stasis and dredging collaterals,etc.should be used flexibly.The commonly used drugs are tonic drugs,drugs for removing wind and dampness,drugs for activating blood circulation and removing blood stasis,heat-clearing drugs,liver-calming and wind-removing drugs.
作者
黄永宾
胡培森
HUANG Yong-bin;HU Pei-sen(Yanling Hospital of TCM,Yanling,Henan,China,461212;The Second Affiliated Hospital of Henan University of CM,Henan Hospital of TCM,Zhengzhou,Henan,China,450002)
出处
《河南中医》
2020年第3期411-414,共4页
Henan Traditional Chinese Medicine
基金
河南省医学科技攻关计划项目(2018)(2018020727)。
关键词
强直性脊柱炎
从肾督辨治
从脾胃辨治
从痰浊、瘀血辨治
肾虚督寒证
寒湿阻滞证
瘀血痹阻证
湿瘀互结证
ankylosing spondylitis(AS)
syndrome differentiation and treatment from kidney and governor vessel
syndrome differentiation and treatment from the spleen and stomach
syndrome differentiation and treatment from phlegm and blood stasis
syndrome of kidney deficiency and governor vessel cold
syndrome of cold dampness blockage
syndrome of stagnation of blood stasis and obstruction
syndrome of stagnation of dampness and blood stasis
