欧阳惠欣 杨海梅 郑宝林

[摘要] 目的 以文献检索为基础探讨临床运用经方治疗类风湿关节炎的应用特点。 方法 检索“知网”数据库，收集1994年8月～2019年8月符合研究的文献，提取中医证型、证候、方药等信息，进行统计分析。 结果 共纳入文献105篇，病案及临床实验159条;证型以寒热错杂、湿热痹阻、风寒湿痹为主;类方以桂枝类方、附子类方、黄芪类方、麻黄类方为主;中药功效以解表补虚、化瘀除风湿、温里为主。 结论 经方治疗类风湿关节炎以解表止痛或温阳止痛为法，并以除湿祛瘀治标，补中扶正治本。

[关键词] 文献研究;类风湿关节炎;经方

[中图分类号] R274          [文献标识码] A          [文章编号] 1673-7210（2020）07（a）-0136-04

[Abstract] Objective To explore the characteristics of classical prescriptions in the treatment of rheumatoid arthritis （RA） by exploring literature. Methods “CNKI” database was searched， the literature in accordance with the research from August 1994 to August 2019 was collected， traditional Chinese medicine syndrome type， syndrome， prescription and other information were extracted， and statistical analysis was made. Results A total of 105 references， 159 medical records and clinical experiments were included. Syndrome types were mainly cold and heat syndrome， damp heat syndrome and wind cold syndrome. Guizhi， Fuzi， Huangqi and Mahuang were the main prescriptions. Main function of traditional Chinese medicine was to relieve the exterior and tonify the deficiency， remove the blood stasis， remove the rheumatism and warm the interior. Conclusion Classical prescriptions are applied to relieve pain by dispersing wind and cold or warming yang. Also they suppress the symptom by dispelling wind and dampness and removing blood stasis to promote blood circulation， treat the root by strengthening body resistance.

[Key words] Literature resaerch; Rheumatoid arthritis; Classical prescriptions

類风湿关节炎（RA）是一种以滑膜增生及持续失控的炎症为特征的免疫性疾病，表现为对称性关节炎，可伴乏力、关节僵硬及发热等[1]，符合祖国医学“痹病”的范畴。经方治疗RA有良好的效果，辨证与用药的准确性是经方治疗本病的关键。目前关于经方治疗RA的临床应用特点文献较少，缺乏系统性整理。故本研究对相关的现代医案与临床实验进行系统整理，总结其证候要点及用药特点，为临床提供借鉴。

1 资料与方法

1.1 文献调查法

结合文献调查法，使用检索式在“中国知网（CNKI）”对经方治疗RA的文献进行筛选，检索时限为1994年8月～2019年8月，根据所检索文献的题目和摘要，排除非中医药、非经方治疗RA相关研究的文献。

1.2 文献选择标准

1.2.1 文献纳入标准  ①文中对RA有明确诊断;②以经方（来源于《金匮要略》《伤寒论》）为主要治疗方法;③针对RA的临床实验研究、病案报道;④同篇文献中的不同病例报道;⑤取得确切临床疗效。……