摘要
介绍陈洪教授分期论治痛风的临床经验。陈洪教授认为,痛风的核心病机为本虚标实,以脾肾亏虚为根本,痰瘀浊毒互结为标,三焦气机失调为关键枢纽。浊毒内蕴贯穿疾病始终,与现代医学高尿酸血症及炎症反应密切相关。临证分期论治:无症状高尿酸血症期,以化痰降浊为主,药用土茯苓、薏苡仁、萆薢等,结合药膳调理;急性发作期,重在清热化痰,通络止痛;发作间歇期,攻补兼施,健脾补肾兼化湿泄浊;慢性关节炎期,健脾补肾为主,佐以通络散结,以四藤一仙汤为基础方加减。注重三大原则:固肾调脾、通补兼施;斡旋三焦气机;痰瘀并治、通络消癥。临证分期辨证遣方用药,尚结合现代药理学研究结果,运用具有降尿酸作用的中药,获得良好效果。
This paper presents Professor CHEN Hong's clinical experience in stage-specific treatment of gout.Professor CHEN holds that the core pathogenesis of gout is"root deficiency with branch excess,"in which spleen-kidney deficiency constitutes the root,turbid phlegm and blood stasis interwine as the branch,and disturbed qi movement in the triple energizer serves as the pivotal link.Internal accumulation of turbid toxins persists throughout the disease course and closely correlates with hyperuricemia and inflammatory responses in modern medicine.In clinical practice,he treats by stages:during asymptomatic hyperuricemia,he focuses on resolving phlegm and descending turbidity with Chinese medicines such as Smilacis Glabrae Rhizoma,Coicis Semen and Dioscorea Hypoglauca together with medicated diet;during acute attacks,he emphasizes clearing heat,resolving phlegm,unblocking collaterals,and relieving pain;in the intercritical period,he combines attack and supplementation,strengthening spleen and kidney while draining damp-turbidity;and in the chronic arthritic stage,he takes fortifies spleen and kidney as the main strategy,assisted by unblocking collaterals and dispersing masses with modifications of the classic Siteng Yixian Decoction.He stresses three key principles:to reinforce the kidney and regulate the spleen while combining tonification with unblocking,to harmonize qi movement of the triple energizer,and to treat both phlegm and stasis to unblock collaterals and eliminate masses.Clinical prescriptions are selected and modified according to syndrome differentiation at each stage,and modern pharmacological findings are integrated to employ uric-acid-lowering herbs,yielding favorable therapeutic outcomes.
作者
吴思瑶
黄桂琼
陈洪(指导)
WU Siyao;HUANG Guiqiong;CHEN Hong(Instructor)(Huizhou Hospital of Guangzhou University of Chinese Medicine,Huizhou Guangdong 516001,China;Department of Cardiology,Huizhou Hospital of Guangzhou University of Chinese Medicine,Huizhou Guangdong 516001,China;Department of Pulmonology,Huizhou Hospital of Guangzhou University of Chinese Medicine,Huizhou Guangdong 516001,China)
出处
《新中医》
2025年第24期182-186,共5页
New Chinese Medicine
基金
第七批全国名老中医药专家学术经验继承项目(国中医药人教函[2022]76号)
第五批全国中医优秀临床人才研修项目(国中医药人教函[2022]1号)。
关键词
痛风
脾肾亏虚
痰瘀互结
分期论治
陈洪
Gout
Spleen-kidney deficiency
Phlegm blended with blood stasis
Stage-specific treatment
CHEN Hong
