基于伏邪理论研究痛风治疗

吴倩 倪青

摘要 伏邪是指潜伏于人体，留恋伏藏，后而逾时而发的邪气。痰浊、瘀血、湿热是痛风最主要的伏邪，是病情发展及发作的重要病理因素，贯穿于疾病的整个过程。中医通过辨病与辨证相结合，确定疾病的分期及性质，对不同伏邪的辨证，对证选法，相应地予以化痰消饮、行气活血、化浊祛湿等治法，对法选方，祛除伏藏的邪气，早期截断，可有效改善痛风患者的临床症状，延缓病情发展，提高患者生命质量。

关键词 伏邪;痛风;中医;治疗;痰浊;瘀血;湿热

Abstract Fuxie refers to the pathogenic qi that lurks in the human body and attack at a specific time after it is hidden.For gout，phlegm turbidity，blood stasis and damp heat are the most important fuxie.They are important pathological factors for the development and attack of gout disease，which pass through the whole process of disease.Traditional Chinese medicine determines the stage and nature of the disease and analysis different evils by combining disease identification and syndrome differentiation.As for the syndrome differentiation of different fuxie，traditional Chinese medicine choose the treatment methods such as Huatan Xiaoyin，Xingqi Huoxue，Huazhuo Qushi etc.according to the syndrome type.Then choose prescription according to the method to get rid of hidden pathogenic qi and cut off early，which can effectively improve the clinical symptoms of patients with gout，delay the development of the disease，and improve the quality of life of patients.

Keywords Fuxie; Gout; Traditional Chinese medicine; Treatment; Phlegm turbidity; Blood stasis; Damp heat

中图分类号：R242;R249;R589.7文献标识码：Adoi：10.3969/j.issn.1673-7202.2021.19.018

痛風是常见的内分泌代谢性疾病，属于中医学“痛风”“痹证”“历节”“黄汗”等范畴，《金匮要略》有云：“诸肢节疼痛，身体尪羸，脚肿如脱。”《丹溪心法·痛风》有云：“痛风者四肢历节走痛，方书谓之白虎历节风证是也。”《格致余论·痛风论》有云：“痛风者，大率因血受热已自沸腾，其后或涉冷水，或立湿地，或卧当风，寒凉外搏，热血得寒，污浊凝涩，所以作痛;夜则痛甚，行于阴也。”现代医学研究发现痛风是由嘌呤代谢紊乱及尿酸排泄异常引起的代谢性疾病，目前中国高尿酸血症的患病率为13.3%，痛风患病率为1.1%[1]。本病早期具有隐匿性，多为高尿酸血症，临床无明显症状，致使尿酸晶体在软组织、关节、软骨和肾脏中沉积，临床表现为反复发作的关节炎或肾脏病变[2]，发病时出现红、肿、热、痛，疼痛剧烈，严重影响患者生命质量。痛风的病理机制复杂，现代研究发现痛风除高水平尿酸外还存在炎症反应，具有反复发作、发生并发症影响预后等特点，西医治疗效果明确，但不良反应明显[3]。……