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寒湿痹阻型类风湿关节炎中医治疗进展

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类风湿关节炎(rheumatoid arthritis,RA)是一种侵蚀性损害的自身免疫性疾病,主要表现为关节的疼痛,关节肿胀,以及关节晨僵。RA长期侵害患者的多关节,最终导致关节畸形,丧失关节功能,随着病程的延长,在一定程度上加重了患者的心理压力和经济负担。RA可以发生在任何年龄,多见于女性,男性发病率随年龄的增长而增长。目前,关于RA的发病机制尚不清楚,可能与免疫紊乱、内分泌紊乱、炎症应答、组织损伤等相关。现代医学研究认为RA与多种因素有关,主要包括遗传因素、环境因素、免疫因素等。在治疗的策略上提倡早期强化治疗和达标治疗,主要的治疗方法包括糖皮质激素、非甾体抗炎药、改善病情的抗风湿药、生物制剂等。在中医学中并没有RA这一病名,其归属于"痹证"范畴。中医学对RA的病因病机进行了深入的研究与阐述,其分为内外因,内因为正气不足,肝肾亏虚,脾胃虚弱等,外因为风寒湿,痰瘀毒等邪侵袭,在治疗上方法众多疗效显著,主要包括经典方剂、针灸推拿、中药贴敷、中药熏蒸等疗法。文章通过查阅近年来文献就RA的病名、病因病机以及对寒湿痹阻型RA的认识及不同治疗方法进行综述,为中医药治疗提供依据。
Research Progress in TCM Treatment of Rheumatoid Arthritis with Cold and Dampness Obstruction
Rheumatoid arthritis(RA)is a debilitating autoimmune disease characterized by joint pain,joint swelling,and morning stiffness.The disease affects the multiple joints of patients for a long time,eventually leading to joint deformity and loss of joint function.With the prolongation of the disease course,it aggravates the psychological pressure and economic burden of pa-tients to a certain extent.The disease can occur at any age,but is more common in women and increases in men with age.At present,the pathogenesis of rheumatoid arthritis is not clear,but may be related to immune disorder,endocrine disorder,inflam-matory response,tissue damage,etc.Modern medical research believes that the disease is related to many factors,including ge-netic factors,environmental factors,immune factors and so on.In terms of treatment strategies,early intensive treatment and standard treatment are advocated.The main therapeutic methods include glucocorticoid,non-steroidal anti-inflammatory drugs,traditional antirheumatic drugs for improving the condition,biological agents,etc.There is no rheumatoid arthritis in the medicine of the motherland,which belongs to the category of"Bi syndrome".Chinese medicine has conducted in-depth re-search and explanation on the etiology and pathogenesis of RA,which can be divided into internal and external causes,internal causes of lack of positive qi,deficiency of liver and kidney,weakness of spleen and stomach,and external causes of evil invasion of wind,cold and dampness,phlegm,blood stasis and poison.In terms of treatment,there are numerous effective methods,mainly including:classical prescriptions,acupuncture and massage,Chinese medicine paste,traditional Chinese medicine fumi-gation and other therapies.By referring to the literature in recent years,the author summarized the disease name,etiology and pathogenesis of RA as well as the understanding of cold-dampness arthralgia type RA and different treatment methods,providing the basis for TCM treatment of this disease.

rheumatoid arthritistraditional Chinese medicine treatmentcold and dampness arthralgia

李贵、黄刚

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新疆医科大学中医学院,新疆乌鲁木齐 830011

类风湿关节炎 中医治疗 寒湿痹阻

国家自然科学基金

81560819

2024

实用中医内科杂志
辽宁省中医药学会,中华中医药学会,辽宁省中医药研究院

实用中医内科杂志

影响因子:0.421
ISSN:1671-7813
年,卷(期):2024.38(3)
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