基于"二十四节气圆运动"理论探讨类风湿关节炎的辨证论治OA

Rheumatoid arthritis,as a chronic and systemic immune disease that invades joints,is character-ized by a high disability rate and is prone to recurrence in clinical practice.PENG Ziyi's theory of"circular movement of the twenty-four solar terms"centers on the ascending,descending,floating and sinking of yang-qi.It holds that the pathogenesis of rheumatoid arthritis is closely related to the disordered circular circulation of yang-qi.It manifests as follows:during autumn(from Start of Autumn to Frost's Descent),the dysfunction of yang-qi to convergence causes phlegm-stasis to obstruct the joints;in winter(from Start of Winter to Major Cold),the failure of yang-qi to store and consolidate induces cold bi-syndrome to yang deficiency;in spring(from Start of Spring to Grain Rain),the abnormal ascent and dispersion of yang-qi,along with wind pathogen triggers latent pathogen,causing wind bi-syndrome;and in summer(from Start of Summer to Major Heat),the disorder floating and exuberance of yang-qi brings about heat-toxin obstruction bi-syndrome.In terms of treat-ment,the emphasis is placed on conforming to the seasonal changes of yang-qi in accordance with the solar terms and restoring the order of circular movement.Specifically,in autumn,the treatment should focus on diffu-sing and descending lung-qi,nourishing yin and moistening dryness;in winter,tonifying the kidney and war-ming yang,dispelling cold and dredging collaterals;in spring,soothing and nourishing the liver,expelling wind and eliminating pathogens;in summer,warmly tonifying spleen yang,clearing heat and removing dampness.Based on the theory of the"Circular Movement of the Twenty-Four Solar Terms",this paper profoundly discus-ses the essential pathogenesis of rheumatoid arthritis and the corresponding treatment strategies based on solar term differentiation,and establishes an individualized syndrome differentiation and treatment system for rheuma-toid arthritis.It can provide a novel theoretical basis and practical therapeutic approach for the clinical manage-ment of rheumatoid arthritis.