以濕熱痺為突出表現之類風濕性關節炎中醫治療報告

Case Report of Rheumatic Arthritis characteristic with Presentation of Damp Fever Arthromyodynia Healed by Traditional Chinese Medicine

林襄穎(Xiang-Ying Lin)

《北台灣中醫醫學雜誌》 4卷1期 (2012/06) Pp. 71-83

https://doi.org/10.30127/BTWZYYXZZ.201206.0006

摘要

類風濕性關節炎是一種慢性發炎性疾病，主要影響多發關節磨損破壞而終至變形或失能，係屬重大傷病，西醫治療現已進步到生物製劑之使用，然中醫亦不遑多讓，精確辨證論治對關節疼痛進一步改善常有令人意想不到的良好效果。本病案描述一位64歲女性罹患類風濕性關節炎多年，中醫參與診療後診斷為肝腎陰虛，復感外邪濕熱，久而痰瘀互結遂成痺症，尤突出表現濕熱痺。患者經由短短六次的中醫治療其疼痛已明顯改善，發炎指標CRP數據下降，並且減少了西藥劑量。另外由於台灣地處濕熱之域，加之個別病患體質常見真陰不足，因此病邪侵犯人體有所謂「從陽化熱」之理，是以濕熱痺常見，本病案也特別針對濕熱痺探討了眾醫家闡述之病因病機，並實踐於本病案的治療。

關鍵字

類風濕性關節炎 ； 濕熱痺 ； 中醫

並列摘要

Rheumatoid arthritis is a chronic inflammatory disease, it is mainly led to multiple joints wear and damage, even deformed or disability, it is classified as a catastrophic disease. In western medical treatment, it is progressively applying biological agents. As for TCM, the accurate treatment based upon syndrome differentiation of joint pain would further improve good results more than expectation. This case report described a 64-year-old female suffering from rheumatoid arthritis for many years, TCM physician participate in clinic diagnosed as liver and kidney deficiency, and the patient also suffered wind-dampness and dampness-heat intermingled, than the stasis of phlegm and blood over time contribute to the formation of arthralgia syndrome, particularly the presence of a fixed impediment and arthralgia due to damp fever arthromyodynia. After six rounds of using treatment based upon syndrome differentiation of TCM, the arthralgia had been significantly improved, inflammatory markers (CRP) had declined, and patient reduced the dosage of western medicine. Besides, due to subtropical damp heat climate of Taiwan with deficiency of genuine Ying in the constitution of each patients, the rheumatic arthritis fever arthromyodynia is frequently seen clinically. This case report discussed etiology and mechanism from theories of many Chinese medical doctors, especially focusing on discussing arthralgia due to damp fever arthromyodynia, and apply our theory in the treatment of the rheumatoid arthritis patient.

並列關鍵字

Rheumatoid Arthritis ； Arthralgia due to Damp Fever Arthromyodynia ； Traditional Chinese Medicine (TCM)