摘要
本文总结马玉琛教授治疗幼年型特发性关节炎(JIA)的经验。马玉琛教授将“阳气怫郁”理论引入JIA的辨证论治中,主张从病因、病机、病位、病变4个维度辨析JIA,风寒湿三气入侵,儿童发育未全,肾水不足,卫阳之气起而抗邪,阴虚阳盛,玄府闭塞,卫阳之气不得散发,怫郁而热,热而蕴毒,因此病性主为风湿热,病位五体主在皮,在骨,五脏主在肾。要谨防其变,化热蕴毒、化痰生结、邪伤正气等。提出祛风散寒除湿以治外因;滋补肾阴,鼓舞正气以治内因;活血行气,宣痹通络以治其机;调补脾肾,恢复脏腑功能以治其位;清热解毒,化痰散结以防其变;壮骨补肾,固本祛邪,收尾不留邪。组方遣药,切其因机,顾其稚嫩,壮其肾骨,起到鼙鼓之应。这为中医药治疗JIA提供有价值的经验方法。
This article summarizes Professor Ma Yuchen’s experience in the treatment of juvenile idiopathic arthritis(JIA).Professor Ma Yuchen introduces the theory of“stagnation of yang qi”into treatment based on syndrome differentiation of JIA,advocates distinguishing JIA from four dimensions:etiology,pathogenesis,location,and lesion,invasion of wind,cold,and dampness,incomplete development of children,insufficient kidney water,activation of wei-yang qi to resist pathogen,yang excessiveness due to yin deficiency,blocked of xuanfu,wei-yang qi unable to disperse,stagnation causing heat,and heat causing toxicity,therefore,the main nature of the disease is wind,dampness,and heat,the main location in skin and bone among the five body parts,five zang viscera are mainly located in kidney.It is necessary to be vigilant against its complications,such as heat accumulation and toxicity,phlegm formation and nodules,and pathogen damage to the body’s vital energy.Propose dispelling pathogenic wind,dispelling cold and removing dampness to treat external cause;nourishing kidney yin,stimulating positive qi to treat internal cause;promoting qi for activating blood circulation,promoting obstruction and unblocking meridians to treat pathogenesis;regulating and tonifying spleen and kidney,restoring zang fu viscera function to treat location;clearing heat and removing toxicity,dissipating phlegm and resolving masses to prevent lesion;strengthening bone and tonifying kidney,strengthening foundation and eliminating evil,leaving no evil at the end.The prescription and medication are based on etiology and pathogenesis,taking into account delicacy of children,and strengthening kidney and bone,achieving a good response.This provides valuable experience and method for traditional Chinese medicine and pharmacy in the treatment of JIA.
作者
孙瑶
马玉琛
张艳
SUN Yao;MA Yuchen;ZHANG Yan(Graduate School,Hebei University of Chinese Medicine,Hebei Province,Shijiazhuang050091,China;Famous Traditional Chinese Medicine Doctor Studio,Baoding Hospital,Guang’anmen Hospital,China Academy of Chinese Medical Sciences,Hebei Province,Baoding071000,China;Department of Oncology,Baoding Hospital,Guang’anmen Hospital,China Academy of Chinese Medical Sciences,Hebei Province,Baoding071000,China)
出处
《中国医药导报》
2026年第1期137-141,共5页
China Medical Herald
基金
河北省保定市科技计划项目(2241ZF272)。
关键词
幼年型特发性关节炎
中医药
“阳气怫郁”
玄府
经验
Juvenile idiopathic arthritis
Traditional Chinese medicine and pharmacy
“Stagnation of yang qi”
Xuanfu
Experience
