金明秀教授治疗类风湿关节炎的经验总结
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摘要
类风湿关节炎(RA)是一种常见的以慢性对称性多关节炎病变为主的全身性自身免疫性疾病,以慢性滑膜炎症,关节进行性破坏为特征。临床表现可见双手、腕、肘、膝、踝和足关节的疼痛、肿胀及晨僵、可有发热、皮下结节、血管炎、心包炎等关节外表现。目前认为与遗传、感染、激素水平、环境等因素相关。祖国医学认为类风湿关节炎归属于中医“痹证”、“痹病”、“历节”等范畴,认为是人体正气不足或脏腑功能失调,风寒湿热燥等外邪侵袭,造成经脉气血不通不荣,出现的以肢体关节肌肉疼痛、重着、麻木、肿胀、屈伸不利,甚者关节变形,或累及脏腑为特征的一类疾病。病情复杂,迁延不愈,给患者的生活,工作带来诸多不便,严重的影响了患者的生活质量。导师金明秀教授经过多年临床实践总结,有着自己独特的理论认识和治疗体会,得出了一套治疗类风湿性关节炎的有效方法,认为正气亏虚是RA发病的内在因素,风寒湿邪侵袭是疾病发病的外在因素,血瘀是疾病的基本特征。因此治疗上主张以益肾温阳、祛风除湿、活血通络的药物为主,自拟经验方,并在其基础上灵活应用,辨证论治。在治疗过程中形成了扶正祛邪、攻补兼施等用药特点,取得了较好的临床疗效。
Rheumatoid arthritis (RA) is a common disease with chronic symmetrical polyarthritis mainly systemic autoimmune disease, with chronic synovitis disease, joints characterized by destruction. Clinical manifestations can be seen with both hands, wrist, elbow, knee, ankle and foot joint pain, swelling and morning stiffness, may have fever, subcutaneous nodules, vasculitis, pericarditis, and other extra-articular manifestations. Currently that genetic, infection, hormone levels, environmental factors related. Rheumatoid arthritis medicine that country belong to Chinese medicine, "Arthralgia", "Bi disease ","Calendar Day"and other areas, that is not the body upright or dysfunctional organs, and other evils invasion of cold dry heat, causing blood unreasonable meridians No glory, there's the body joint and muscle pain, weight forward, numbness, swelling, flexion and extension negative, fraudulent claims joint deformity, or involving the organs of a class of diseases characterized. Complex disease, delayed healing, to the patient's life, work inconvenience, serious impact on the patient's quality of life. Mentor Professor Jin Mingxiu concluded after many years of clinical practice, has its own unique theoretical understanding and treatment, a treatment of rheumatoid arthritis obtained an effective method, that deficiency is the RA disease righteousness internal factors, the wind cold dampness evil invasion Is a disease of the external factors, blood stasis is the basic characteristics of the disease. Therefore, treatment advocates kidney yang, dispelling wind and dampness, activating blood and the drug network-based, self experience side, based on the flexibility in its application of dialectical theory of governance. Gradually formed in the course of treatment rousing, supplementation and other drugs attack characteristics, and achieved better clinical efficacy.
Rheumatoid arthritis (RA) is a common disease with chronic symmetrical polyarthritis mainly systemic autoimmune disease, with chronic synovitis disease, joints characterized by destruction. Clinical manifestations can be seen with both hands, wrist, elbow, knee, ankle and foot joint pain, swelling and morning stiffness, may have fever, subcutaneous nodules, vasculitis, pericarditis, and other extra-articular manifestations. Currently that genetic, infection, hormone levels, environmental factors related. Rheumatoid arthritis medicine that country belong to Chinese medicine, "Arthralgia", "Bi disease ","Calendar Day"and other areas, that is not the body upright or dysfunctional organs, and other evils invasion of cold dry heat, causing blood unreasonable meridians No glory, there's the body joint and muscle pain, weight forward, numbness, swelling, flexion and extension negative, fraudulent claims joint deformity, or involving the organs of a class of diseases characterized. Complex disease, delayed healing, to the patient's life, work inconvenience, serious impact on the patient's quality of life. Mentor Professor Jin Mingxiu concluded after many years of clinical practice, has its own unique theoretical understanding and treatment, a treatment of rheumatoid arthritis obtained an effective method, that deficiency is the RA disease righteousness internal factors, the wind cold dampness evil invasion Is a disease of the external factors, blood stasis is the basic characteristics of the disease. Therefore, treatment advocates kidney yang, dispelling wind and dampness, activating blood and the drug network-based, self experience side, based on the flexibility in its application of dialectical theory of governance. Gradually formed in the course of treatment rousing, supplementation and other drugs attack characteristics, and achieved better clinical efficacy.
引文
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[2]冯兴华.类风湿关节炎的中医治疗[J].中华全科医师杂志,2005,03(4):146-147
[3]李广文.辨证治疗类风湿性关节炎16例[J].辽宁中医杂志,2004,3(11O):839.
[4]雷裕后.分期辨治类风湿性关节炎32例[J].实用中医药杂志,2004,20(3):127
[5]杨增文.浅谈类风湿关节炎的中医辨证治疗[J].中国中医药现代远程教育,2010,21(8):146
[6]黎威.独活寄生汤治疗类风湿关节58例[J].辽宁医学院学报,2009 ,30(3):240
[7]王旭等.通痹汤治疗类风湿关节炎32例临床观察[J].山西中医,2009 ,0(625):20-21
[8]王念莲等.五苓散治疗类风湿关节炎30例[J] .现代中西医结合杂志, 2009 ,1(84):416
[9]余建华等.桂枝芍药知母汤治疗活动期类风湿关节炎72例临床观察[J] .江苏中医药, 2010 ,5(42) :37-38
[10]廖晶莹.自拟苍柏灵仙汤治疗类风湿关节炎活动期疗效观察[J].中医药临床杂志, 2010, 1(22):52-53
[11]王君琴.尪痹汤治疗风寒湿型类风湿关节炎临床观察[J].中医中药,2009, 32(6):61-62
[12]李勇.顽痹汤治疗类风湿关节炎31例例临床观察[J].云南中医中药杂志,2009, 8(30):41
[13]崔丽等.热痹方治疗湿热型类风湿关节炎30例疗效观察[J].河北中医,2009 ,4(31):521
[14]吴国发.益气活血通脉汤治疗类风湿关节炎120例[J].河北中医2009, 5(31):727
[15]邓金风等.加昧防己茯苓汤加艾灸治疗类风湿关节炎的临床观察[J].按摩与康复医学,2010 ,5(14):7
[16]王光权等.自拟中药风湿饮治疗类风湿关节炎30例[J].中国医学创新,2010 ,30(7)65-66
[17]喻建平.刮莎治疗类风湿关节炎临床观察[J].实用中西医结合临床,2005 ,2(5):52-53
[18]王永亮.埋线配合火针治疗类风湿关节炎120例[J].上海针灸杂志,2004, 10(23):31
[19]杨勇等.中药熏洗治疗类风湿关节炎疗效观察[J].光明中医,2009 ,6(24): 1066-1067
[20]陈萍等.中药外敷治疗类风湿关节炎的观察及护理[J].中华实用中西医杂志, 2010 ,04(23):13-15
[21]吴芙蓉.针灸综合疗法治疗类风湿关节炎120例[J].湖北中医杂志,2010,11(32):57