张敏从“郁-痹-虚”论治类风湿关节炎经验介绍
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R249;R255.6

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广东省中医药局科研项目(20251054)


Introduction to ZHANG Min's Experience in Treating Rheumatoid Arthritis from the Perspective of "Stagnation-Obstruction-Deficiency"
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    摘要:

    张敏教授经过长期临床实践,提出可从“郁-痹-虚”认识类风湿关节炎(RA) 病机及传变规律,认为气机郁滞为发病之始,郁久可致病理产物郁滞,痰瘀互结闭阻经络发为“痹”,痹久耗伤气血、损及肝肾而终致“虚”。治疗上,张教授以疏解郁滞为核心治则贯穿始终,早期以柴胡疏肝散加减以疏郁祛邪,并从内、外两方面论治;进展期在早期的基础上根据六郁不同的偏重进行加减以疏调郁滞、化瘀通痹;晚期以柴胡疏肝散合独活寄生汤化裁以补虚扶正、散郁除痹。本文系统阐述张教授从“郁-痹-虚”论治RA的学术经验,对临床有一定启示作用。

    Abstract:

    Abstract: Based on long-term clinical practice, Professor ZHANG Min proposed that the pathogenesis and transmission rules of rheumatoid arthritis (RA) can be understood from the perspective of "stagnation-obstructiondeficiency." Professor ZHANG considers that qi stagnation is the onset of the disease;prolonged stagnation leads to the accumulation of pathological products,then phlegm blends with blood stasis to obstruct the meridians,which manifests as obstruction;prolonged obstruction consumes qi and blood,damages the liver and kidney,and ultimately results in deficiency. In terms of treatment, Professor ZHANG takes relieving stagnation as the core therapeutic principle throughout the course. In the early stage, modified Chaihu Shugan Powder is used to relieve stagnation and eliminate pathogens, with treatment approaches addressing both internal and external aspects. In the progressive stage, modifications are made based on the early-stage prescription according to the predominant type among the six types of stagnation, aiming to alleviate stagnation, resolve blood stasis, and unblock obstruction. In the advanced stage, a modified Chaihu Shugan Powder plus Duhuo Jisheng Decoction is used to tonify deficiency and support the healthy qi, as well as to disperse stagnation and remove obstruction. This paper systematically elaborates on Professor ZHANG′s academic experience in treating RA from the perspective of "stagnation-obstruction-deficiency, " with the aim of providing certain clinical insights.

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张婷玮,麦晓露,张敏.张敏从“郁-痹-虚”论治类风湿关节炎经验介绍[J].新中医,2026,58(18):179-184

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  • 在线发布日期: 2026-09-29
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