邱新萍 孙颂歌 孙莹 张红红 阎小萍

摘要 阎小萍老师认为，强直性脊柱炎（AS）的核心病机为肾督阳气不足，风寒湿热诸邪深侵肾督;在防治方面重视“治未病”思想的应用，主要体现在：1）未病先防，倡导扶助正气、精神恬淡，重视健康宣教;2）既病防变、防残，中药治疗以补肾强骨通络为主，根据脏腑辨证、循经辨证，随证加减用药，防止AS患者发生目疾改变、骨量减少、骨质疏松以及髋关节病变，防止关节畸形、致残，同时重视体育锻炼及非药物治疗;3）瘥后防复，恢复期患者注意调畅情志，饮食宜清淡，禁烟酒，定期门诊复诊，遵医嘱坚持服药，防止复发。

关键词 强直性脊柱炎;“治未病”;目疾;骨量减少;骨质疏松;髋关节病变;关节畸形; @ 阎小萍

Clinical Application of YAN Xiaoping′s Academic Thought of Preventive Treatment of Ankylosing Spondylitis

QIU Xinping1，SUN Songge1，SUN Ying1，ZHANG Honghong1，YAN Xiaoping2

（1 Department of Rheumatology，Shunyi Hospital，Beijing Hospital of Traditional Chinese Medicine，Beijing 101300，China; 2 Department of Traditional Chinese Medicine Rheumatology，Department of China-Japan Friendship Hospital，Beijing 100029，China）

Abstract Professor YAN Xiaoping believes that the core pathogenesis of ankylosing spondylitis is kidney deficiency and yang deficiency，the evils of wind，cold，dampness and heat deeply invade the kidney.In the prevention and treatment of AS，Yan Xiaoping attaches great importance to the application of the “treat disease” principle，which is mainly reflected in：1）AS prevention before disease，mainly advocates helping righteousness，calm spirit，and attaches great importance to health education; 2）AS is both disease prevention and prevention disability.Traditional Chinese medicine treatment is based on tonifying the kidney and strengthening the bones and collaterals.According to the syndromes of the internal organs and syndrome differentiation，the addition and subtraction of the drugs can prevent the occurrence of eye disease changes，bone loss，osteoporosis，and hip joint disease in patients with AS，prevent joint deformity and disability.At the same time，we should pay attention to physical exercise and non-drug treatment; 3）prevent relapse after resuscitation.Patients in the recovery period should pay attention to clear mood，light diet，non-smoking alcohol，regular outpatient follow-up，and follow the doctor′s advice to adhere to medication to prevent AS recurrence.

Keywords Ankylosing spondylitis; “prevention of disease before it arises”; Eye disease; Bone mass decreased; Osteoporosis; Hip joint disease; Joint deformity; @ Yan Xiaoping

中圖分类号：R681.5;R259文献标识码：Bdoi：10.3969/j.issn.1673-7202.2021.17.022

阎小萍（1945—），女，主任医师，博士研究生导师，第四、五、六批全国名老中医药专家学术经验继承工作指导老师，首都国医名师，焦树德老师学术经验继承人。阎老师从事中医、中西医结合治疗风湿病临床与科研工作50年，尤其对强直性脊柱炎（Ankylosing Spondylitis，AS）、类风湿性关节炎、干燥综合征、骨关节炎等的诊治有较丰富的经验。阎小萍老师学术思想体现在重视中医辨证的整体观、平衡观和动态观，基于“寒热为纲”辨证，逐步确立风湿病“肾虚为本，寒热为标”的病机，运用“补肾壮骨、祛寒止痛”“补肾壮骨，清热化湿”的治则。AS是一种主要侵犯骶髂关节、脊柱骨突、脊柱旁软组织及外周关节的慢性炎症性疾病，可伴发关节外表现，严重者可发生脊柱畸形和强直[1]。……