基于"扶阳通痹"理论探讨乌梅丸治疗围绝经期类风湿关节炎经验OACSTPCD

Perimenopausal rheumatoid arthritis(RA) is a refractory disease with complex pathogenesis and prolonged recovery. It can be classified within the scope of bi syndrome(impediment syndrome) in traditional Chinese medicine(TCM). Historically,medical experts have mainly focused on treating liver and kidney yin deficiency and regulating qi and blood,while overlooking the important role of yang qi. This article elaborates on the close relationship between yang qi and bi syndrome. It proposes that the depletion of tiangui(the essence of the kidney) and yang deficiency leading to water-cold syndrome are important pathological bases for the onset of perimenopausal RA patients. This condition can evolve into a complex pathogenesis involving the loss of wei qi's ability to protect the body,the loss of warmth around Zhongwan(CV12),liver yang deficiency,transformation of stagnant liver qi into heat,and the complicated interaction of phlegm and stasis generating cold and heat. Therefore,treatment should focus on warming and tonifying kidney yang,promoting liver yang circulation,and clearing stagnant heat to achieve the effect of "reinforcing yang to relieve impediment". Clinically,modified Wumei Pills(Mume Pill) can be effective by warming the kidneys,restoring the free action of the liver,dispelling stasis,and opening collaterals,with the aim of achieving satisfactory clinical result.