[1]肖妮沁,陈冰冰,晏和国,等.麻黄细辛附子汤治疗风寒湿痹型类风湿关节炎研究进展[J].陕西中医,2025,46(11):1573-1576.[doi:DOI:10.3969/j.issn.1000-7369.2025.11.025]
　XIAO Niqin,CHEN Bingbing,YAN Heguo,et al.Research progress of Mahuang Xixin Fuzi decoction in treatment of wind-cold-dampness Bi syndrome rheumatoid arthritis[J].,2025,46(11):1573-1576.[doi:DOI:10.3969/j.issn.1000-7369.2025.11.025]
点击复制

麻黄细辛附子汤治疗风寒湿痹型类风湿关节炎研究进展
分享到：

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
46
期数:
2025年11期
页码:
1573-1576
栏目:
综 述
出版日期:
2025-11-05

文章信息/Info

Title:
Research progress of Mahuang Xixin Fuzi decoction in treatment of wind-cold-dampness Bi syndrome rheumatoid arthritis
作者:
肖妮沁1; 陈冰冰1; 晏和国1; TIEU Bao ngan2(越南); 谢招虎1; 李兆福1
（1.云南中医药大学,云南 昆明 650500；2.广西中医药大学国际教育学院,广西 南宁 530001）
Author(s):
XIAO Niqin1; CHEN Bingbing1; YAN Heguo1; TIEU Bao ngan2(Vietnam); XIE Zhaohu1; LI Zhaofu1
(1.Yunnan University of Chinese Medicine,Kunming 650500,China；2.Guangxi University of Chinese Medicine,Nanning 530001,China）
关键词:
麻黄细辛附子汤; 风寒湿痹证; 类风湿关节炎; 药理作用; 信号通路; 抑郁
Keywords:
Mahuang Xixin Fuzi decoction; Wind-cold-dampness Bi syndrome; Rheumatoid arthritis; Pharmacological action; Signaling pathway; Depression
分类号:
R 593.22
DOI:
DOI:10.3969/j.issn.1000-7369.2025.11.025
文献标志码:
A
摘要:
类风湿关节炎（RA）是一种以对称性多关节炎为主要表现的慢性自身免疫性疾病，其病因尚未完全阐明。该病的基本病理特征包括滑膜炎性增生、血管翳形成、软骨及骨破坏，严重者可导致关节畸形，并累及多脏器。中医学将RA归属于“痹证”范畴，其中风寒湿痹型RA患者常表现为关节冷痛及抑郁等症状。西医治疗以缓解症状和延缓病情进展为主，虽有一定疗效，但存在不良反应明显，对风寒湿痹型RA患者的关节冷痛、抑郁等症状改善有限。麻黄细辛附子汤具有散寒止痛、温阳通络之效。“阳气者，精则养神，柔则养筋”，阳气充足，能有效改善患者抑郁症状，提示该方通过“抗炎-神经调节”双重途径发挥治疗作用，体现了中医“形神同治”的整体观。本研究对麻黄细辛附子汤治疗风寒湿痹型RA进行探讨，为临床科研提供参考。
Abstract:
Rheumatoid arthritis (RA) is a chronic autoimmune disease primarily characterized by symmetrical polyarthritis,and its etiology has not been fully elucidated.The fundamental pathological features of this disease include synovial inflammatory hyperplasia,pannus formation,as well as cartilage and bone destruction.In severe cases,it can lead to joint deformities and involve multiple organs.Traditional Chinese medicine (TCM) classifies RA under the category of “Bi syndrome,”among which patiens with RA of wind-cold-dampness Bi syndrome often exhibiting symptoms such as cold and painful joints along with depression.Western medical treatment mainly focuses on symptom relief and slowing disease progression.Although it shows certain efficacy,it is associated with significant adverse reactions and has limited effectiveness in improving symptoms such as cold and painful joints and depression in patients with RA of wind-cold-dampness Bi syndrome.Mahuang Xixin Fuzi decoction has effects of dispelling cold,relieving pain,warming yang,and unblocking meridians.As the saying goes,“When Yang Qi is abundant and refined,it nourishes the spirit.When it is gentle,it nourishes the tendons.”Sufficient Yang Qi can effectively improve patients’ depressive symptoms,suggesting that this formula may exert therapeutic effects through a dual pathway of “anti-inflammation and neural regulation,”reflecting the holistic concept of TCM in treating both the physical and mental aspects simultaneously.This study explores the treatment of RA of wind-cold-dampness Bi syndrome with Mahuang Xixin Fuzi decoction,aiming to provide reference for clinical and scientific research.

参考文献/References:

[1]FIRESTEIN G S,MCINNES I B.Immunopathogenesis of rheumatoid arthritis[J].Immunity,2017,46(2):183-196.
[2]王小蕊,李文倩,解友邦,等.托法替尼联合传统DMARDs类药物治疗类风湿性关节炎临床效果观察[J].陕西医学杂志,2023,52(12):1727-1730.
[3]姜楠,田新平,曾小峰.《2024中国类风湿关节炎诊疗指南》解读[J].协和医学杂志,2025,16(1):28-34.
[4]梁倩倩,茅建春,肖涟波,等.类风湿关节炎中西医结合诊疗专家共识[J].世界中医药,2023,18(7):923-928,935.
[5]彭江云,狄朋桃,方春凤,等.云南地区类风湿关节炎中医证候学研究[J].中国中医药信息杂志,2012,19(7):15-17.
[6]许飞,唐超炫,周文强,等.4028例类风湿关节炎患者中医证候回顾分析[J].云南中医学院学报,2019,42(2):38-41.
[7]刘维,李闯,吴沅皞.类风湿关节炎中医证型地域性分布特征的文献研究[J].中华中医药杂志,2015,30(9):3349-3352.
[8]白菁安,杨洁,何小鹃.不同辨证体系中类风湿关节炎中医病机研究进展[J].陕西中医,2024,45(10):1428-1430，1434.
[9]LI H B,WU L J,JIANG N,et al.Treatment satisfaction with rheumatoid arthritis in patients with different disease severity and financial burden:A subgroup analysis of a nationwide survey in China[J].Chin Med J(Engl)，2020,133(8):892-898.
[10]程增玉,徐浩东,唐晓颇.Notch信号通路在活动性类风湿关节炎中的作用[J].中国免疫学杂志,2023,39(9):1965-1969.
[11]程伟刚,李浩林,杨娟娟,等.中医药调控PI3K/Akt信号通路治疗类风湿关节炎的研究进展[J].中药新药与临床药理,2024,35(5):756-764.
[12]袁如月,许波.基于网络药理学和生物信息学研究麻黄附子细辛汤治疗类风湿关节炎的潜在机制[J].风湿病与关节炎,2020,9(4):6-10，15.
[13]练志润,张家蔚,何剑峰,等.基于中医理论结合药理探讨《伤寒论》中的麻黄发汗禁忌[J].环球中医药,2024,17(3):477-481.
[14]张瑜,张红,李宁,等.细辛化学成分和药理作用的研究进展及其质量标志物的预测分析[J].天然产物研究与开发,2023,35(10):1794-1807.
[15]王成,何长国.麻黄附子细辛汤抗心律失常的作用机制探究[J].中医药临床杂志,2024,36(10):1920-1925.
[16]唐锋,梁少瑜,陈飞龙，等.血清药物化学和血清药理学相结合的方法探讨麻黄附子细辛汤抗炎和免疫抑制的物质基础[J].中国中药杂志,2015,40（5）:1971-1976.
[17]刘书宇,王树鹏.麻黄细辛附子汤对变应性鼻炎大鼠INF-γ与IL-13含量的影响[J].河南中医,2017,37(8):1370-1372.
[18]张艺,李廖英子,韩爱庆,等.麻黄细辛附子汤拆方干预CD4+T细胞调控相关细胞因子分泌及STAT6 mRNA表达的研究[J].中国中医急症,2021,30(6):950-954.
[19]韩隆胤,任晓杰,王强，等.麻黄细辛附子汤治疗类风湿关节炎作用机制的网络药理学分析[J].中药新药与临床药理,2020，31(10):1173-1181.
[20]张昺磊,张志明,朱鹏,等.麻黄附子细辛汤的化学成分及药理作用研究进展[J].现代中西医结合杂志,2023,32(9):1304-1308.
[21]LI W,WANG K,LIU Y,et al.A novel drug combination of mangiferin and cinnamic acid alleviates rheumatoid arthritis by inhibiting TLR4/NFκB/NLRP3 activation-induced pyroptosis[J].Front Immunol，2022,13:912933.
[22]HU L,LIU R,ZHANG L.Advance in bone destruction participated by JAK/STAT in rheumatoid arthritis and therapeutic effect of JAK/STAT inhibitors[J].Int Immunopharmacol，2022,111:109095.
[23]DAI L,CHEN X,ZHANG H,et al.RND3 transcriptionally regulated by FOXM1 inhibits the migration and inflammation of synovial fibroblasts in rheumatoid arthritis through the Rho/ROCK pathway[J].Published Correction Appears in J Interferon Cytokine Res，2022,42(6):279-289.
[24]倪钰莹,孙彤彤,范淑月,等.麻黄细辛附子汤干预Notch通路调控Treg细胞纠正Th2偏移的研究[J].中国中医急症,2023,32(2):200-203，216.
[25]李亮,陈昱丞,王强,等.麻黄附子细辛汤对阳虚型非小细胞肺癌小鼠PI3K/Akt/mTOR信号通路的影响[J].现代中医药,2022,42(2):43-48.
[26]孙明月,李洪霖,冯保荣,等.麻黄附子细辛汤联合环磷酰胺对肺癌大鼠JAK/STAT通路的作用[J].中国老年学杂志,2023,43(13):3208-3212.
[27]杨阳,王树鹏.基于NF-κB信号通路探讨麻黄细辛附子汤对变应性鼻炎大鼠NF-κBp65、p-CREB和AQP5表达的影响[J].辽宁中医杂志,2019,46(12):2662-2665.
[28]刘书宇,王树鹏.基于NF-κB信号通路探讨麻黄细辛附子汤对变应性鼻炎大鼠MUC5AC和MUC5B表达影响[J].辽宁中医药大学学报,2019,21(12):41-43.
[29]范淑月,吴璐蔚,孙彤彤,等.基于Rho/ROCK信号通路探讨麻黄细辛附子汤对小鼠树突状细胞迁移的影响[J].中国实验方剂学杂志,2024,30(18):35-42.
[30]李肖,秦晴,王小帆,等.麻黄附子细辛汤合桃红四物汤加味治疗类风湿性关节炎30例临床观察[J].中国民族民间医药,2019，28(7):110-112.
[31]温伟强,黄胜光,陈辉,等.蜂针和麻黄附子细辛汤加味治疗风湿寒性关节痛42例[J].山东中医杂志,2011,30(6):401-402.
[32]王树强.麻黄细辛附子汤加味治疗痹证32例[J].河南中医，2012，32(6):677-678.
[33]沈鑫鑫.麻黄附子细辛汤熏洗治疗尪痹（类风湿关节炎）寒湿痹阻证的临床优化研究[D].长春：长春中医药大学,2024.
[34]李娜,袁佺,张杰.麻黄附子细辛汤蜡疗治疗寒湿痹阻型类风湿关节炎疗效观察[J].辽宁中医杂志,2022,49(2):90-93.
[35]任明彪.麻黄附子细辛汤加减联合火针治疗类风湿性关节炎寒湿痹阻证80例[J].湖南中医杂志,2016,32(5)：61-62.
[36]樊姝宁,陈聪爱,徐文秀,等.国医大师王庆国教授从少阴阳气论治抑郁症的临证经验特色[J].天津中医药大学学报,2025,44(2):101-105.
[37]秦竹,秦越,籍莉,等.麻黄附子细辛汤对心境障碍抑郁型大鼠模型行为学影响的研究[J].江西中医药大学学报,2017,29(2):70-71，116.
[38]陈党红.朱良春教授温肾壮督治痹证对《伤寒论》治法的发展[J].新中医,2013,45(9):159-160.
[39]王雪茜,闫军堂,刘敏,等.王庆国教授治疗类风湿性关节炎的辨治思路与用药特色[J].现代中医,2015,22(7):40-43.
[40]刘维超,杨会军,吴晶金,等.从阳虚邪凑论治类风湿关节炎[J].四川中医,2015,33(10):22-24.

备注/Memo

备注/Memo:
国家自然科学基金资助项目（82260928）；云南省高层次科技人才及创新团队选拔专项项目（202305AS350007）；云南省基础研究专项重点项目（202301AS070076）
更新日期/Last Update: 2025-11-04