王鑫 张羽 吕行 李诗雨 李南南 周彩云

摘要 白塞病是一种以血管炎为基本病理改变的慢性全身性炎症疾病，病变可累及多系统，病情复杂，缠绵难愈。周彩云教授主张中西医结合治疗白塞病，提出了分期辨治的治疗原则，认为“湿热毒邪内蕴、热毒伤络”为本病病机关键，急性活动期关键病机为“湿热毒邪内蕴、热毒伤络”，治疗应以清热解毒、凉血护络为大法，可兼以清热利湿;间歇期病机特点为“脾气亏虚、湿热毒余邪内蕴、络脉受损”，治疗应益气健脾，兼清热解毒利湿、凉血护络。

关键词 白塞病;分期辨治;周彩云;经验;贝赫切特综合征;中医药;急性活动期;间歇期

Abstract Behcet′s disease is a chronic systemic inflammatory disease with vasculitis as the basic pathological change.The disease can affect multiple systems with complex conditions and is very easy to relapse.Professor ZHOU Caiyun advocates integrated Chinese and Western medicine for Behcet′s disease.She proposes treatment based on stage differentiation and considers that the essential pathological mechanism is not only dampness-heat toxin amassment but also collaterals injury caused by heat toxin.In acute active phase，the key pathogenesis is dampness heat and pathogenic toxin accumulated in interior and heat-toxicity hurting collateral.The main treatment should be clearing heat and removing toxicity，cooling blood and protecting collaterals，assisted by promoting dieresis.In intermission，the main pathological mechanism is deficiency of spleen qi，remnant dampness-heat toxin，and damaged collaterals，which can be treated by replenishing qi and invigorating spleen，with the main treatment at acute phase as its assistance.

Keywords Behcet′s disease; Staged syndrome differentiation treatment; Professor ZHOU Caiyun; Clinical experience; Behet syndrome; Traditional Chinese medicine; Acute active phase; Intermission

中图分类号：R259;R59文献标识码：Bdoi：10.3969/j.issn.1673-7202.2021.09.024

白塞病（Behcet Disease）又称贝赫切特综合征（Behet Syndrome，BS）是一种慢性全身性血管炎症疾病，曾被人们称为“口-眼-生殖器三联征”，主要表现为复发性口腔溃疡、生殖器溃疡、眼炎及皮肤损害，也可累及血管、神经系统、胃肠道和关节等器官[1]。本病在地中海、中东和东亚地区高发，又称丝绸之路病，在我国并非罕见，发病率大约为14/10万，男性居多[2-3]。本病病因尚未明确，基本病理为血管炎，所有类型血管均可受累，2012年Chapel Hill系统性血管炎分类标准将BD定义为变异性血管炎[4]。BD病情复杂多变，轻者可自行緩解，重者能危及生命，难于治愈。大量遗传学研究也证实BD是一个多基因位点的复杂疾病[5]。因此，BD属于风湿免疫疾病中的疑难病。目前西医尚无特效方法，治疗主要采用非甾体抗炎药、糖皮质激素、免疫抑制剂、生物制剂等，上述药物疗程长，停药病情易反复。……