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1、山西中医2009年3月第25卷第3期SHANXIJOFTCMMar2009Vol25No31学术探讨风湿病辨治探讨谭维勇摘要:风湿病属中医痹证范畴。其主要病因病机是:患者先天禀赋不足或后天失养,气血不足,腠理空虚,风、寒、湿、热诸外邪侵袭,气血运行不畅,经络痹阻,筋脉关节脏腑失于濡养而致;既病之后,又易与内生痰、瘀等内外合邪;后期转归复杂,多表现为虚实夹杂、寒热互见、阴阳失调。临证应结合病因、病程、病种辨证治疗;用药注意调和阴阳、切中病机、顾护胃气;把握辨病与辨证结合的原则,合理应用祛风
2、与祛湿药。关键词:风湿病;辨治;思路中图分类号:R593文献标识码:A文章编号:1000-7156(2009)03-0001-04ApproachofRheumatisminDeterminationofTreatmentBasedonDifferentiationofSyndromesTANWeiyong(Long-huaHospitalAffiliatedtoShanghaiUniversityofChineseMedicine,Shanghai,200032,China)Abstract:Rheumati
3、smbelongstoarthromyodyniacategoryinTCM.Itsetiologicalfactormainlyareinnatedeficiencyandlossofpostnatalnurse.Soinsufficiencyofqiandbloodandvacuityofstriaeoftheskincouldleadtodiseasesattackingaswellaswind,coldness,wetnessandhotnessraiding.Afterdiseaseoccurs,endogeno
4、ussputumandstasisstrikefromwithoutandinsidewithaboveevils.Theturnoverinlaterstageisverycomplicated,andsymptomsareinclusionofastheniaandsthenia,coldnessandhotnessshowingupatthesametimeandimbalanceofyinandyang.Inclinicalpracticedifferentiationofsymptomsandsignstode
5、cidetreatmentshouldbeaccordingtodifferentetiologicalfactorandpathogenesis,differentstagesanddifferentdiseases.Medicationsouldlaystressonharmonizingyinandyang,soastoshootatetiologicalfactorthatistosayshootingthearrowatthetarge.tGastricqishouldbeattendedinanytimes
6、oadvancementandretreatmentathome.Thefollowinglawshouldbeabidedbythatsyndromedifferentiationiscapitalanddifferentialdiagnosisofdiseasesislesser.Theadvantagesanddisadvantagesofthedrugsofeliminatingwindanddispellingdampnessshouldbepaidattentiontoandspeciesanddosagesh
7、ouldbeadjustedintime.Keywords:rheumatism,determinationoftreatmentbasedondifferentiationofsymptomsandsigns,thinkingway风湿病是指风湿免疫病,属结缔组织病,泛指程变化均为内外合邪,胶着为害。一切发生于皮肤、筋膜、肌腱、关节及肌肉和内脏基本病机为正虚邪凑,留滞筋骨血脉,正虚为结缔组织的与自身免疫功能紊乱有关而不能用感本,以肺卫不足、肝肾阴虚、脾肾阳虚为主,随着病染、肿瘤、外伤等原因解释的疾病。风湿病属中医程进
8、展则见阴阳俱损、五脏皆虚。邪气为标,风、痹证范畴。中医很早就认识到风湿病引起系统损寒、湿、热诸邪气具有致病特异性和选择性,并因五害的情况,如!内经∀中提及的#五脏痹∃。下面结脏阴阳偏颇,而侵袭不同脏腑经络。风邪易侵袭肌合文献研究与临证体会,对风湿病的辨治进行探表肺卫,寒入肾脏,湿易困脾,火热犯心,在外表
