| 引用本文: |
黄小尧, 刘燕君, 江佳蓉, 胡锋杰, 陈阳, 刘新.基于“络病-扶阳”理论探讨桂枝附子汤对寒湿痹阻型痛风性关节炎的治疗[J].湖南中医药大学学报,2025,45(5):945-949[点击复制] |
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| 基于“络病-扶阳”理论探讨桂枝附子汤对寒湿痹阻型痛风性关节炎的治疗 |
| 黄小尧,刘燕君,江佳蓉,胡锋杰,陈阳,刘新 |
| (新疆医科大学中医学院, 新疆 乌鲁木齐 830011;新疆医科大学第四临床医学院, 新疆 乌鲁木齐 830000) |
| 摘要: |
| 痛风性关节炎（GA）属于中医学“痹证”范畴，随着中医学对络病学的深入探究，GA的发生、发展与络脉病变密切相关。通过分析寒湿痹阻型痛风性关节炎（CD-GA）不同时期发病机制与络脉发病特点，从邪伏、邪阻、邪伤络脉进行论述，络脉的病变是CD-GA的病理基础，寒挟湿浊内侵为发病关键。基于“络病”和“扶阳”理论，论述扶阳通络之剂桂枝附子汤治疗CD-GA的作用，并提出无症状高尿酸血症期病机为络脉伏湿，治以扶阳祛湿通络；痛风急性发作期病机为邪阻络脉，治以扶阳通络止痛；慢性GA期和痛风性肾病期病机为邪伤络脉，治以扶阳扶正荣络。探讨桂枝附子汤在CD-GA不同时期的组方原理，完善桂枝附子汤的组方配伍，提供桂枝附子汤的临床使用思路。 |
| 关键词: 痛风性关节炎 痹证 寒湿 桂枝附子汤 扶阳 络病 |
| DOI：10.3969/j.issn.1674-070X.2025.05.024 |
| 投稿时间：2024-10-31 |
| 基金项目:国家自然科学基金资助项目（81860834）；新疆维吾尔自治区自然科学基金资助项目（2021D01C264）。 |
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| Treating gouty arthritis of cold-dampness impediment type with Guizhi Fuzi Decoction based on the theory of "collateral disease-fortifying yang" |
| HUANG Xiaoyao, LIU Yanjun, JIANG Jiarong, HU Fengjie, CHEN Yang, LIU Xin |
| (College of Chinese Medicine, Xinjiang Medical University, Urumqi, Xinjiang 830011, China;The Fourth Clinical Medical College of Xinjiang Medical University, Urumqi, Xinjiang 830000, China) |
| Abstract: |
| Gouty arthritis (GA) falls under the category of impediment pattern in Chinese medicine. With the deepening exploration of collateral disease theory in Chinese medicine, the occurrence and progression of GA are closely related to pathological changes in the collaterals. By analyzing the pathogenesis of cold-dampness impediment type gouty arthritis (CD-GA) at different stages and its characteristics in collateral disease, this paper discusses the disease mechanisms in terms of the hidden pathogenic factors, collateral obstruction, and collateral damage, highlighting that collateral pathology serves as the pathological basis of CD-GA, with cold accompanied by dampness-turbidity invasion being the key trigger. Based on the theory of "collateral disease-fortifying yang", this study elucidates the therapeutic effects of Guizhi Fuzi Decoction as a core formula for fortifying yang and unblocking collaterals in treating CD-GA. The following mechanisms and treatments are proposed as follows. Asymptomatic hyperuricemia stage: Pathogenesis involves dampness lurking in the collaterals—treatment focuses on fortifying yang, dispelling dampness, and unblocking collaterals; Acute gout attack stage: Pathogenesis involves pathogen obstructing the collaterals—treatment prioritizes fortifying yang, unblocking collaterals, and alleviating pain; Chronic GA stage & gouty nephropathy stage: Pathogenesis involves pathogen damaging the collaterals—treatment emphasizes fortifying yang, strengthening healthy qi, and nourishing collaterals. This study explores the formula rationale of Guizhi Fuzi Decoction for CD-GA at different stages, refines its compatibility principles, and provides clinical application strategies for its use. |
| Key words: gouty arthritis impediment pattern cold-dampness Guizhi Fuzi Decoction fortifying yang collateral disease |
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