摘要
甲氨蝶呤是治疗类风湿关节炎的基础用药,其胃肠道不良反应突出。中医学认为不良反应普遍存在,合理配伍用药则能减毒增效,“以通为用,以降为和”是对六腑生理特点的凝练,“通”与“降”是六腑生理机能的核心,通降失司是甲氨蝶呤药后胃肠道不良反应的核心。“脾”与“胃”,“肺”与“大肠”,“肝”与“胆”相互关系失调是通降失司的具体病机,采用辛开苦降、清利肺肠、疏肝健脾等法,能够指导临床。
Methotrexate is the basic medicine for the treatment of rheumatoid arthritis,and its gastrointestinal side effects are prominent.Traditional Chinese medicine believes that adverse reactions are common,and reasonable compatibility of medicines can reduce toxicity and increase efficacy.“unstopping for use,reduction for harmony”is a condensing of the physiological characteristics of the six fu viscera.“unstopping”and“descending”are the core of the physiological function of the six fu organs,unstopping and descending disharmony is the core of gastrointestinal adverse reactions after Methotrexate.The relationship between“spleen”and“stomach”,“lung”and“large intestine”,and“liver”and“gallbladder”are the specific pathogenesis of unstopping and descending disharmony,the method of dispersing with pungent medicinals and descending with bitter medicinals,clearing lung and big intestines,soothing liver and fortifying spleen can guide clinical practice.
作者
徐浩东
程增玉
唐晓颇
周新尧
姜雯
李达
庞枫韬
XU Haodong;CHENG Zengyu;TANG Xiaopo;ZHOU Xinyao;JIANG Wen;LI Da;PANG Fengtao(Department of Rheumatism,Guang’anmen Hospital,China Academy of Chinese Medical Sciences,Beijing100053,China)
出处
《中国医药导报》
CAS
2022年第12期116-119,133,共5页
China Medical Herald
基金
国家自然科学基金面上项目(81873281)
“十三五”国家重点研发计划项目(2018YFC1705200)。
关键词
类风湿关节炎
甲氨蝶呤
以通为用
以降为和
胃肠道
不良反应
Rheumatoid arthritis
Methotrexate
Unstopping for use,reduction for harmony
Gastrointestinal tract
Adverse reaction
作者简介
徐浩东(1992.6-),男,中国中医科学院广安门医院2019级中医内科学专业在读博士研究生,主要从事风湿免疫病的中医药临床与研究;通讯作者:唐晓颇(1970.9-),男,博士,主任医师,博士、博士后导师,研究方向:中医药防治风湿免疫病临床及基础研究。
