[1]周 琨,何东初,杨 琦.基于“玄府-气液”理论探讨辛味药在痛风性关节炎治疗中的应用[J].陕西中医,2024,(11):1517-1520.[doi:DOI:10.3969/j.issn.1000-7369.2024.11.016]
 ZHOU Kun,HE Dongchu,YANG Qi.Based on theory of Xuanfu Qiye application of pungent drugs in treatment of gouty arthritis[J].,2024,(11):1517-1520.[doi:DOI:10.3969/j.issn.1000-7369.2024.11.016]
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基于“玄府-气液”理论探讨辛味药在痛风性关节炎治疗中的应用
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《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2024年11期
页码:
1517-1520
栏目:
学术探讨
出版日期:
2024-11-05

文章信息/Info

Title:
Based on theory of Xuanfu Qiye application of pungent drugs in treatment of gouty arthritis
作者:
周 琨1何东初12杨 琦3
(1.湖北中医药大学第一临床学院,湖北 武汉 430060; 2.解放军中部战区总医院,湖北 武汉 430070; 3.武汉市红十字会医院,湖北 武汉 430024)
Author(s):
ZHOU KunHE DongchuYANG Qi
(First Clinical College of Hubei University of Traditional Chinese Medicine,Wuhan 430060,China)
关键词:
痛风性关节炎 玄府气液 辛香流气 辛润通络 辛味药 开玄通络
Keywords:
Gouty arthritis Xuanfu gas and liquid Spicy fragrance flows Xinrun Tongluo Pungent medicine Kaixuan Tongluo
分类号:
R 593
DOI:
DOI:10.3969/j.issn.1000-7369.2024.11.016
文献标志码:
A
摘要:
痛风性关节炎是一种常见的炎性关节疾病,临床以受累关节反复剧痛,红肿发热,功能障碍,甚则畸形为主要表现,病情反复,证候多变,后期常影响肾脏功能。玄府是中医学对人体微观结构的认识,具有形态微细、数量众多、遍布周身的特点,为气液升降出入之门户,对气液宣散、沟通、交换起着重要作用。玄府以开为顺,开阖失司则精微不布,化痰生湿而致痛风。辛味药具有能化、能补、能润、能通、能升的特性,可开玄启闭,宣通气液。本文基于玄府气液学说,并结合痛风性关节炎的临床特点,提出了正虚邪犯,玄府壅塞是始发因素。气液失司,化湿生热为关键病机; 痰瘀搏结,耗气伤津为中心环节; 玄府失充,迁延反复乃病理结局。临床上灵活使用辛味药化湿、清热、剔痰、祛瘀、补虚,使玄府得通,气液畅达,以期从中医微观层面为辛味药开通玄府,治疗痛风性关节炎提供新视角。
Abstract:
Gouty arthritis is a common inflammatory joint disease,characterized by recurrent severe pain,redness,swelling,fever,functional impairment,even deformities in affected joints.The condition was recurrent,syndrome variable and affects renal function in the later stage.Xuanfu was traditional Chinese medicine understanding of the microstructure of human body,characterized by its fine morphology,numerous quantities,and coverage throughout body.It serves as gateway for the flow of gas and liquid,playing an important role Xuanfu prioritizes opening and closing,while opening and closing without proper attention to detail can lead to the transformation of phlegm and dampness,resulting in gout.Spicy drugs have characteristics of being able to transform,replenish,moisturize,unblock and elevate.They can open and close mysteries,promote flow of gas and liquid.Based on the Xuanfu gas liquid theory and combined with clinical characteristics of gouty arthritis,proposing that the disease is characterized by the invasion of positive Qi,deficiency,and evil,with Xuanfu obstruction as initiating factor.The key pathogenesis is the loss of gas and liquid,and transformation of dampness and heat generation.Phlegm stasis and consuming gas and damaging fluids were the central factors that affect the body's function.The pathological outcome is the loss of power in the Xuanfu and the repeated extension.It is flexible to use spicy medicine to dispel dampness,clear heat,remove phlegm,remove blood stasis and supplement deficiency,so as to make the Xuanfu clear and gas and liquid flow unobstructed,in order to provide new perspective for treatment of gouty arthritis with spicy medicine from micro level of traditional Chinese medicine.

参考文献/References:

[1] KELLER S F,MANDELL B F.Management and cure of gouty arthritis[J].Medical Clinics of North America,2021,105(2):297-310.
[2] 杨丽华,刘晓丽,蒋雅琼,等.我国痛风的患病率及危险因素[J].医学研究杂志,2019,48(12):4-6,10.
[3] 戴政文,钟传棋,杨志新.桂枝芍药知母汤治疗痛风性关节炎急性期疗效及对患者可调节相关因子与嘌呤受体水平变化的影响[J].陕西中医,2024,45(1):67-70.
[4] 张静雯,王利,赵敏,等.核苷酸结合寡聚化结构域样受体蛋白3介导细胞焦亡在痛风性关节炎中的作用机制研究[J].陕西医学杂志,2022,51(5):561-565.
[5] 刘维.痛风及高尿酸血症中西医结合诊疗指南[J].中医杂志,2023,64(1):98-106.
[6] 杨琦,陈晓雯.祛湿泄浊法治疗痛风性关节炎的研究进展[J].巴楚医学,2022,5(3):103-105.
[7] 王琼潇,粟胜勇,苏虹,等.基于玄府理论探讨针刺开阖补泻的临床应用[J].陕西中医,2023,44(8):1094-1097.
[8] 张雯迪,岳冬辉.中医玄府学说内涵探析[J].中华中医药杂志,2021,36(6):3216-3218.
[9] 刘完素.素问玄机原病式[M].北京:中国医药科技出版社,2019:33.
[10] 向圣锦,段俊国.玄府:细胞层次物质能量信息流通与交换的结构和功能单位[J].中华中医药杂志,2022,37(9):5491-5493.
[11] 杨琦,陈晓雯.基于“玄府-伏毒-肝络”理论论治非酒精性脂肪性肝病[J].中西医结合肝病杂志,2023,33(5):442-443.
[12] 李鑫,展立芬,覃思敏,等.玄府理论在偏头痛防治中的运用[J].陕西中医,2021,42(12):1748-1751.
[13] 高梓恬,李勇,冯婵,等.金劲松教授从脾肾论治痛风的经验[J].湖北民族大学学报(医学版),2024,41(1):83-85.
[14] 冯明月,魏军平.魏军平从利湿降浊分期辨证治疗痛风经验浅析[J].世界中西医结合杂志,2023,18(12):2362-2364,2369.
[15] 杨琦,朱昱成,程丽丽,等.基于肠道菌群探讨中医药治疗高尿酸血症及痛风机制[J].风湿病与关节炎,2023,12(11):40-43,80.
[16] 李明,丰纪明,古英,等.李时明治疗痛风临床经验初探[J].四川中医,2022,40(10):1-4.
[17] 曹圣,郭丛丛,张新颖,等.钱秋海从“虚气流滞”论治痛风经验[J].山东中医杂志,2023,42(11):1224-1229.
[18] 冯秋涧,赵捷,赵明,等.基于“宣可去壅”探讨辛味药在抑郁症治疗中的应用[J].上海中医药杂志,2023,57(9):45-48.
[19] 张淼,霍海如,王朋倩,等.辛味药性理论溯源与现代研究评述[J].中草药,2018,49(3):505-511.
[20] 王钊,付广威,郭静怡,等.叶天士辛香流气治络心法述要[J].中华中医药杂志,2024,39(1):464-466.
[21] 张平,方琼.柴胡皂苷D对高尿酸血症大鼠尿酸及相关酶活性的影响[J].大理大学学报,2024,9(2):39-42.
[22] HAN B,ZHU C X,SHI W,et al.Effect of rhizoma polygoni cuspidati and ramulus cinnamomi compatibility on uric acid metabolism and urinary nheutrophil gelatinase-associated lipocalin and kidney injury molecule-1 in rats with hyperuricemia [J].Chinese J of Integrative Medicine,2017,23(7):535-542.
[23] 邢艺缤,朱垚,陆明.芳香类中药临床应用进展[J].中医临床研究,2023,15(15):108-111.
[24] 杜世拔,齐红朝,赵争敏,等.白虎桂枝汤加减治疗急性痛风性关节炎临床研究[J].陕西中医,2020,41(9):1258-1261.
[25] 符芸瑜,张永杰,吴英萍,等.白虎加桂枝汤治疗痛风及对患者血清炎症因子和血尿酸水平的影响[J].陕西中医,2020,41(8):1110-1113.
[26] 刘广宇,宋洪杰,徐西林.桂枝白虎汤对痛风性关节炎大鼠NLRP3炎症小体及TLR4/NF-κB通路的调节作用研究[J].中药材,2023,46(5):1278-1284.
[27] 李建,张洁瑛,孙鹏,等.平胃散合桂枝芍药知母汤加减治疗慢性痛风性关节炎的疗效机制[J].中国实验方剂学杂志,2018,24(1):180-185.
[28] 曹建康,汲泓.虫类药治疗痛风的应用探讨[J].中医药临床杂志,2021,33(10):1911-1914.
[29] 代琪,李康曦,叶俏波,等.僵蚕化学成分、药理作用及毒理学研究进展[J].中国药物评价,2023,40(5):402-408.
[30] 朱雅楠,杨素清,崔晓倩,等.全蝎软膏的药理作用及临床应用研究进展[J].中医药学报,2023,51(6):99-104.
[31] 万金圣,刘涛.叶天士辛润通络法探析[J].中国中医基础医学杂志,2024,30(4):569-571.
[32] 陈辉,黎德育,邓泽军.丹参川芎嗪注射液联合双氯芬酸纳治疗急性痛风性关节炎疗效及安全性研究[J].临床军医杂志,2017,45(3):290-291,294.
[33] RAWISH E,SAUTER M,SAUTER R,et al.Complement inflammation and thrombosis[J].Br J Pharmacol,2021,178(14):2892.
[34] 戴震,韩子茹,裴俊泽,等.甘草附子汤调控巨噬细胞极化治疗痛风性关节炎[J].锦州医科大学学报,2024,45(2):18-23.

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备注/Memo

备注/Memo:
基金项目:国家自然科学基金资助项目(81873153,81273905); 湖北省中医药管理局中医药重点项目(ZY2023Z010)
更新日期/Last Update: 2024-11-11