从"风毒入络"论治类风湿性关节炎OA

Rheumatoid arthritis(RA)is an autoimmune disease characterized by chronic synovitis and joint destruction,which belongs to the categories of"Bi syndrome"and"Lijie disease"in traditional Chinese medicine(TCM).Combined with the modern wind-toxin theory and collateral disease theory,this paper proposes that"wind-toxin invading collaterals"is the core pathogenesis throughout the whole course of RA based on its pathological features and clinical manifestations.In terms of syndrome evolution,RA shows obvious staged characteristics:the early stage is dominated by"defensive yang impairment",the middle stage presents"collateral stasis",and the late stage manifests"zang-fu organ deficiency".According to the theory of"wind-toxin invading collaterals"and disease staging,staged treatment is recommended:The early stage emphasizes dispelling wind,consolidating defensive qi and clearing toxin,mainly using wind-dispelling herbs combined with qi-consolidating agents to halt disease progression;The middle stage focuses on searching wind,unblocking collaterals and attacking toxin,applying vine herbs to unblock collaterals combined with insect herbs to attack toxin;The late stage pays attention to tonifying deficiency,consolidating the constitution and detoxifying,using tonifying herbs to reinforce deficiency and unblock collaterals simultaneously.This therapeutic system fully embodies the TCM preventive idea of"preventing disease progression once it occurs",and provides a new theoretical basis and clinical pathway for the TCM treatment of RA.