仝小林"独藏"辨识治疗痛风性关节炎OA

The clinical manifestations of gouty arthritis are complex.If treatment is based only on joint redness,swelling,heat,and pain,it may be limited to the damp-heat signs of the attack stage.In this case,the patient has recurrent gouty arthritis with aversion to cold,dysuria,and sublingual collateral stasis,while multiple tophi are especially prominent.Tophi are tangible signs of long-standing latent cold-dampness and congealed turbidity-stasis,and their frequent occurrence indicates deeper retention of cold-dampness pathogens and more extensive conglutination.Therefore,"multiple tophi"are identified as the Du Cang symptom.By recognizing dampness through the stones and seeking yang through dampness,the core pathogenesis is clarified as long-standing cold-dampness and impaired yang qi transformation as the root,with constrained heat,toxin accumulation,and turbidity-stasis congealing into stones as the branch.The treatment focuses on eliminating dampness and dissolving stones,warming yang to dispel cold,and activating blood circulation to unblock collaterals.The prescription uses modified Sanjin Huashi Decoction combined with herbs that warm yang,resolve dampness,activate blood,and dissipate masses.This therapy shows significant efficacy.