[1]李 吉,杨 进,白小军,等.李彦民治疗类风湿关节炎经验[J].陕西中医,2023,(6):769-772.[doi:DOI:10.3969/j.issn.1000-7369.2023.06.020]
 LI Ji,YANG Jin,BAI Xiaojun,et al.Li Yanmin's experience in treating rheumatoid arthritis[J].,2023,(6):769-772.[doi:DOI:10.3969/j.issn.1000-7369.2023.06.020]
点击复制

李彦民治疗类风湿关节炎经验
分享到:

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2023年6期
页码:
769-772
栏目:
名中医经验
出版日期:
2023-06-05

文章信息/Info

Title:
Li Yanmin's experience in treating rheumatoid arthritis
作者:
李 吉1杨 进2白小军1Francois Pan1(加拿大)杨 锋12
(1.陕西中医药大学,陕西 咸阳 712046; 2.陕西中医药大学附属医院,陕西 咸阳712038)
Author(s):
LI JiYANG JinBAI XiaojunFrancois PanYANG Feng
(Shaanxi University of Chinese Medicine,Xianyang 712046,China)
关键词:
类风湿关节炎 仙龙汤 络脉痹阻 通络止痛 乌梢蛇
Keywords:
Rheumatoid arthritis Xianlong decoction Paralysis of the veins Relieving pain Zaocys
分类号:
R 684.3
DOI:
DOI:10.3969/j.issn.1000-7369.2023.06.020
文献标志码:
A
摘要:
类风湿关节炎(RA)在中医学中属于“痹病”范畴,是临床中常见的难治性疾病,且呈年轻化趋势,迁延难愈。目前现代医学对RA的发病病因及机制尚不完全清楚。《素问·痹论》提出风寒湿三邪致痹,还有学者提出痰瘀致痹、肝肾亏虚等观点。李彦民主任医师根据多年临床经验提出RA的病机关键是络脉痹阻,其病机特点是虚实夹杂,临床辨证分为寒湿阻络型、湿热蕴结型、痰瘀互结型、气血两虚型、肝肾亏虚型等五型。分别采用祛邪通络和补虚通络等不同治则,辨证施法。李老师善用川乌、鸡血藤以及乌梢蛇等药以通络止痛,并主张辨证用药,内外兼治,多取良效。临床采用经验方仙龙汤,配合外用舒筋活络洗剂,且取得理想疗效。
Abstract:
Rheumatoid arthritis(RA)belongs to the category of “paralysis” in Chinese medicine,and it is a common clinical disease with a tendency to be younger and more difficult to be cured,the control of this disease is extremely important.The etiology and mechanisms of RA pathogenesis are currently unknown in western medicine.In the Suwen·Bilun propose that the three evils of wind,cold and damp cause paralysis,some scholars put forward the viewpoint that phlegm and blood stasis cause arthralgia and deficiency of liver and kidney.Based on years of clinical experience,Dr.LI,believes that the key to the pathogenesis of rheumatoid arthritis is paralysis of the ligaments and veins.The disease mechanism is characterized by a mixture of deficiency and realit.The clinical evidence is divided into five types:cold-damp blocking type,damp-heat accumulation type,phlegm-stasis interconnection type,qi-blood deficiency type,liver-kidney deficiency type,etc.Dr.LI makes good use of rhizomes such as acontit radix and millettia dielsiana,as well as insects such as zaocys,in order to promote the circulation and relieve pain.And advocate dialectical medicine,both internal and external treatment,and many good results.The clinical use of the empirical formula Xianlong decoction,together with the topical application of Shujin Huoluo decoction,and has achieved satisfactory results.

参考文献/References:

[1] 栗占国,张奉春,鲍春德.类风湿关节炎[M].北京:人民卫生出版社,2008:1-2.
[2] 范 列,英宗明,丁媛媛.部分HLA-DRB1等位基因与抗环瓜氨酸肽抗体及类风湿因子的相关性[J].检验医学,2008,23(6):585-589.
[3] 刘蔚翔,姜 泉.中西医治疗类风湿关节炎的研究进展[J].中华中医药杂志,2022,37(12):7251-7257.
[4] 李引刚,刘艳萍.李彦民骨伤临床经验拾粹[M].西安:西安交通大学出版社, 2017:10-11.
[5] 陈婵婵.类风湿关节炎的病因病机[J].临床医药文献电子杂志,2017,4(85):16815.
[6] 王晓灿,王 蓉,高永翔.痹症的病因及证治探讨[J].光明中医, 2015,30(12):2544-2545.
[7] 孙智平,丁艳莉.凤仙骨痛贴联合仙龙汤治疗风寒阻络性关节炎临床观察[J].陕西中医学院学报,2014,37(1):61-63.
[8] 廖晨希,武 平,周旻庆.类风湿关节炎相关中医证型病机探微[J].湖南中医杂志,2019,35(7):115-117.
[9] 严家欣,张荣华.类风湿关节炎中医病因病机研究进展[J].西北国防医学杂志,2017,38(4):272-274.
[10] 许正锦,陈进春,邱明山,等.浅论痰瘀在类风湿关节炎中的致病作用[J].辽宁中医杂志,2018,45(6):1167-1170.
[11] 殷海波,石 白,张锦花.基于痰浊致痹辨治痛风[J].中国中医药信息杂志,2012,19(8):94-95.
[12] 张萌芮,梁 超,张燕珍,等.循经针刺联合身痛逐瘀汤治疗腰椎间盘突出症气滞血瘀证疗效研究[J].陕西中医,2022,43(9):1282-1285.
[13] 吕 明,刘晓艳.唐代以前中医文献对类风湿关节炎中医病机的认识[J].吉林中医药, 2014,34(4):417-418.
[14] 王拥军,梁倩倩,崔学军,等.调和气血法防治慢性筋骨病的应用与发展[J].上海中医药杂志,2017,51(6):1-4.
[15] 时文才,聂晨旭,胡晓龙,等.黄芪桂枝五物汤合血府逐瘀汤联合针灸治疗早期强直性脊柱炎临床研究[J].陕西中医,2020,41(3):315-317,337.
[16] 石 亮,杨 方.以肾为本辨治类风湿关节炎40例[J].陕西中医药大学学报,2018,41(1):66-69.
[17] 孙悦礼,姚 敏,崔学军,等.慢性筋骨病的中医认识与现代理解[J].中医杂志,2014,55(17):1447-1451.
[18] 阳定雨,郑 军,王文昭,等.独活寄生汤治疗慢性筋骨病临床研究进展[J].陕西中医,2021,42(3):405-408.
[19] 杨 茜,宁 珑,许春萍,等.独活寄生汤对胶原性骨关节炎大鼠干预机制[J].陕西中医,2022,43(12):1673-1676.
[20] 杨 进,王晓锋,李彦民.仙龙颗粒治疗类风湿关节炎120例[J].陕西中医,2015,36(9):1204-1205.
[21] 孙智平,张 妮,李彦民.名中医李彦民治疗腰椎间盘突出症专方“黄牛白龙汤”组方研究[J].陕西中医药大学学报,2018,41(6):39-41.
[22] 李彦民,史传道.舒筋活络洗剂的临床应用(附291例临床报告)[J].陕西中医学院学报,1995,18(4):20-22.
[23] 刘艳平,李引刚,王彦辉,等.四生通络贴膏治疗寒凝血瘀型腰椎间盘突出症60例[J].陕西中医,2018,39(9):1263-1265.
[24] 安 新,冯 超,高利常.类风湿关节炎患者血清白细胞介素-32、白细胞介素-17和白细胞介素-10表达水平及临床意义[J].陕西医学杂志,2021,50(12):1585-1588.

相似文献/References:

[1]刘志队,史丽璞.加味桂枝芍药知母汤对活动期寒热错杂型类风湿关节炎患者ESR、CRP和RF调控作用分析*[J].陕西中医,2019,(1):82.
[2]倪丹红,刘 丹,吕琴琴,等.秦息痛片联合传统抗风湿药治疗早期活动性 类风湿关节炎临床研究*[J].陕西中医,2019,(4):484.
[3]刘志队,史丽璞,张铁峰.加味桂枝芍药知母汤治疗寒热错杂型类风湿关节炎临床研究*[J].陕西中医,2019,(7):906.
 LIU Zhidui,SHI Lipu,ZHANG Tiefeng..Clinical analysis of modified Guizhi Fuyao Zhimu decoction in treating cold and hot miscellaneous rheumatoid arthritis[J].,2019,(6):906.
[4]李 锐,叶冰玉△,刘佳钰,等.活血通络汤辨治类风湿关节炎合并肺间质纤维化临床研究*[J].陕西中医,2019,(8):1041.
 LI Rui,YE Bingyu,LIU Jiayu,et al.Brief analysis of Huoxue Tongluo decoction on differentiation and treatment of rheumatoid arthritis with pulmonary interstitial fibrosis[J].,2019,(6):1041.
[5]李 良,孙银娣,李亚峰,等.四妙二藤汤联合双氯芬酸钠对类风湿关节炎患者关节情况、炎症指标和复发率的影响[J].陕西中医,2019,(10):1397.
 LI Liang,SUN Yindi,LI Yafeng,et al.Effect of Simiao Erteng decoction combined with diclofenac sodium on joint condition,inflammation index and recurrence rate in patients with rheumatoid arthritis[J].,2019,(6):1397.
[6]尚 磊,刘 茜△.断藤益母汤甲氨喋呤联合对类风湿性关节炎患者DAS28评分和炎症指标的影响*[J].陕西中医,2019,(10):1400.
 SHANG Lei,LIU Qian..Effect of Duanteng Yimu decoction and methotrexate on DAS28 Score and inflammatory indicators in rheumatoid arthritis patients[J].,2019,(6):1400.
[7]刘 茜,樊亚红△,陈爱林,等.秦息痛药液外敷治疗类风湿关节炎疗效评价*[J].陕西中医,2019,(10):1403.
 LIU Qian,FAN Yahong,CHEN Ailin,et al.Evaluation of the therapeutic effect of external application of Qinxitong liquid onrheumatoid arthritis[J].,2019,(6):1403.
[8]尚磊,李映雪△.补肾通痹汤联合雷公藤多苷治疗老年类风湿关节炎疗效研究*[J].陕西中医,2019,(11):1552.
 SHANG Lei,LI Yingxue..Effect of Bushen Tongbi decoction combined with tripterygium wilfordii polyglycosides in the treatment of eldery rheumatoid arthritis[J].,2019,(6):1552.
[9]杨庆万,安 阳△,项飞燕,等.引火汤对类风湿关节炎患者骨代谢的影响*[J].陕西中医,2020,(1):73.
 YANG Qingwan,AN Yang,XIANG Feiyan,et al.Effect of Yinhuo decoction on bone metabolism in patients with rheumatoid arthritis[J].,2020,(6):73.
[10]田杰祥,王 钢,王 佳,等.中医外治法治疗类风湿关节炎滑膜炎研究进展*[J].陕西中医,2020,(1):131.
 TIAN Jiexiang,WANG Gang,WANG Jia,et al.Research progress of external treatment in the 〖JZ〗treatment of rheumatoid arthritis synovitis[J].,2020,(6):131.

备注/Memo

备注/Memo:
基金项目:陕西省科技厅社会发展领域一般项目(2023-YBSF-210); 陕西省教育厅重点科研计划项目(22JZ034)
更新日期/Last Update: 2023-06-09