摘要
复发性多软骨炎(RP)病情复杂,证候多端,主要累及全身软骨和富含黏多糖的组织,造成多系统损害,属于罕见疑难病,中医对其认知尚未形成共识。本文基于“体脏合痹”理论,分析其与BP的联系,认为BP属于“体脏合痹”范畴,根据BP临床演变规律可分为急性期、持续期与缓解期,进行分期论治。急性期由邪气主导,风热毒蕴,痰瘀热结,免疫失衡,炎症剧烈;持续期多为本虚标实、虚实夹杂之证,伏邪与正气交争,迁延难愈,为RP反复发作的根本病机;缓解期为正虚邪恋,渐至免疫稳态。本病治疗遵循和正调衡原则,辨证以体脏为纲,虚实为目,经络、血脉为合,急性期祛邪解毒、体脏同治、散瘀化痰,持续期扶正祛邪、随证加减、行气和解,缓解期扶正固本、体脏同调、消癥通络。临证时要正确把握疾病阶段,以恢复体、脏正常生理功能,从“体脏合痹”理论分期论治RP,为中医药治疗RP提供新思路。
Relapsing polychondritis(RP)is a rare and challenging disease characterized by complex clinical manifestations and multi-system damage,primarily affecting cartilaginous tissues and mucopolysaccharide-rich structures throughout the body.Within the framework of traditional Chinese medicine(TCM),a consensus understanding of RP has not been established.This article is based on the theory of"combined bi-impediment of body constituents and zang organs"and analyzes its relationship with RP.RP can belong to this category,and based on its clinical progression,a staged treatment approach is recommended across three phases:acute,persistent,and remission.Pathogenetically,the acute phase is dominated by pathogenic factors such as wind-heat toxin accumulation,phlegm-stasis heat coagulation,immune dysregulation,and intense inflammatory responses.The persistent phase transitions into a deficiency-excess complex pattern,marked by a latent pathogen struggle between pathogenic factors and healthy qi,forming the fundamental pathogenesis underlying RP recurrence.The remission phase is characterized by lingering pathogen residues coupled with healthy qi deficiency,gradually progressing toward immune homeostasis.Therapeutically,treatment follows the principle of"harmonizing balance between healthy qi and pathogenic qi,"with the five zang organs and bodily constituents as the framework,deficiency and excess as the objective,and the meridians and blood vessels as the unity.During the acute phase,the approach emphasizes eliminating evil and detoxifying,treating the body and zang organs together,and dispersing blood stasis and phlegm.In the sustained phase,treatment focuses on strengthening healthy qi and eliminating evil,modifying treatments according to syndrome manifestations,promoting qi flow,and resolving and eliminating phlegm.In the remission phase,the body and zang organs are strengthened and regulated,and masses are eliminated and collaterals are dredged.Clinical application requires accurate stage differentiation to restore normal physiological body and zang organ functions.A staged treatment strategy based on the theory of"combined bi-impediment of body constituents and zang organs"may offer novel insights into the TCM-based management of RP.
作者
方创贇
黄筱涵
汪悦
FANG Chuangyun;HUANG Xiaohan;WANG Yue(Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,China)
出处
《北京中医药大学学报》
北大核心
2025年第7期960-965,共6页
Journal of Beijing University of Traditional Chinese Medicine
基金
国家自然科学基金面上项目(No.82274454)。
关键词
风湿免疫病
体脏合痹
复发性多软骨炎
五体痹
五脏痹
rheumatoid and immune diseases
combined bi-impediment of body constituents and zang organs
relapsing polychondritis
five body constituents bi-impediment
five zang organs bi-impediment
