中医学报

痛风性关节炎的病机以脾肾亏虚为本，湿毒瘀为标。脾胃功能失调，气血运行不畅，聚而成水、湿、痰，水湿痰浊聚于体内，痹阻经脉脏腑，郁而化热，久而生瘀，毒邪骤生，引发关节红肿热痛。临证先辨寒热，重视分期论治。急性期以解决关节红肿热痛为主，以祛湿解毒化瘀为治疗大法，创立祛湿解毒化瘀汤。常用丹参、赤芍，土鳖虫、穿山龙，忍冬藤、鸡血藤等药对。缓解期积极鼓励患者继续巩固治疗，以补益脾肾为治疗原则，兼以利湿化浊，方可标本同治，改善预后。常用苍术、白术，伸筋草、威灵仙等药对。

The pathogenesis of gouty arthritis is Spleen and Kidney deficiency being the root cause as well as Dampness, Toxin and stasis being the secondary cause.The Spleen and Stomach dysfunctional results in the poor flow of Qi and blood, and Water, Dampness and Phlegm accumulate in the body, leading to the blockage of the meridians and viscera.Then the stagnation induces Heat and stasis occurs over time.When the Toxin evil factor suddenly arises, symptom of red, swelling, hot and painful joints is induced.In clinical practice, Cold and Heat should be distinguished firstly and treatment in stages should be paid attention to.In the acute stage, the symptom of red, swelling, hot and painful joints should be relieved, with dispelling Dampness, detoxification and removing stasis as the treatment policy, and Qushi Jiedu Huayu Decoction is created for the purpose, in which the drug pairs such as Danshen(salvia miltiorrhiza) and Chishao(red peony root),Tubiechong(ground beeltle) and Chuanshanlong(rhizoma dioscoreae nipponicae),Rendongteng(honeysuckle vine) and Jixueteng(suberect spatholobus stem) are commonly used.During the remission period, patients are actively encouraged to continue the treatment, with the principle of nourishing the Spleen and Kidney as well as dispelling Dampness and eliminating Turbidity, so that the symptoms can be removed, and the prognosis can be improved.The commonly used drug pairs are Cangzhu(rhizoma atractylodis) and Baizhu(white atractylodes rhizome) as well as Shenjincao(herba lycopodii) and Weilingxian(radix clematidis).