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全生讲中医(15)----痛风的中医防治 (8/3/2011)

痛风是一种全身慢性代谢性疾病,因体内嘌呤代谢异常,血中的嘌呤代谢产物——尿酸含量增高所致。高尿酸血症如长期存在,尿酸将以尿酸盐的形式沉积在关节、皮下组织及肾脏等部位,引起关节炎、皮下痛风结石、肾脏结石或痛风性肾病等一系列临床表现。
 
痛风好发于40岁以上的男性,多见于拇趾的跖趾关节,也可发生于其他较大关节,尤其是踝部与足部关节,严重时会造成关节畸形僵硬。随着人们生活水平的提高和饮食结构的变化,痛风患者人数不断增加,并呈现年轻化趋势。据最新统计数字显示,目前中国痛风病潜在发病人数多达上亿,其中约有3500万人已被确诊。痛风除了可以引起关节疼痛、畸形、功能障碍和肾损害外,也可并发糖尿病、冠心病、高血压、肥胖症、血脂紊乱等疾病。
 
痛风的急性发作(也称为急性痛风性关节炎)没有预兆,剧痛常在夜间突然发生,且疼痛部位集中,程度剧烈。同时受累的关节表现为发红、发热和肿胀,局部皮肤发亮,触痛明显。如果不进行预防,每年会发作数次,出现慢性关节症状,并发生永久性破坏性关节畸形。
 
痛风性关节炎在临床上属于中医的“痹症”、“湿浊”范畴。是因饮食失宜,脾肾不足,外邪痹阻,痰瘀沉积于关节周围,以拇趾、跖趾关节、足背、足跟、踝、指、腕等小关节红肿剧痛反复发作,关节畸形,形成“痛风石”为主要表现的肢体痹病类疾病。中医讲究个体化治疗,根据患者的不同体质,不同病型,不同的发病时间,不同的年龄阶段,采用不同组成的方药合剂。针对风湿热痹证,治法为清热通络,祛风除湿;针对风寒湿痹证,治法为祛风散寒,除湿通络;针对痰瘀痹阻证,治法为活血化瘀,化痰通络;针对气血不足,肝肾亏虚证,治法为补益气血,调补肝肾,祛风胜湿,活络止痛。
痛风的急性发作多为湿热内蕴,脉络瘀阻。治疗原则是清热利湿,通经活络。针刺疗法,具体用穴为曲池、合谷、神门、足三里、太冲、丰隆、内庭、阴陵泉等。手法用泻法,每周治疗两次,12次为一个疗程。通常2 ~3次即可直折病势,安神定痛。
 
对于痛风病静止期的患者,可采用针刺疗法进行调补,以预防痛风发作。应该以补脾肾为主,增加排泄机能。临床可选曲池、合谷、足三里、关元、气海、水道等穴,手法为补法,每周两次,12次为一疗程。也可以长期采用针刺疗法进行调补,改善体质。
2010年三月中医杂志报道,有人采用针灸结合中药治疗痛风性关节炎34例,结果是21例痊愈,13例改善,文章最后结论是针灸中药治疗痛风性关节炎有效。
 
痛风的预防非常重要。合理控制饮食,不吃含高嘌呤食物如动物内脏脑、肝、肾、心、肚,胰脏,不吃龙虾,蟹、牡蛎等海鲜、贝壳类水产等;少吃中等嘌呤食物如各种肉,豆制品,花生;多喝水;多吃蔬菜水果; 适当参加体育活动。
 
肥胖、糖尿病与痛风有一定关联的,有人认为肥胖、痛风和糖尿病是三联症,肥胖可诱发高尿酸血症和高血糖。所以在痛风的治疗过程中,患者不仅需要减轻体重和控制高脂肪食物的摄入,而且应对并发的糖尿病进行治疗。
 
另外,两首小方,对治疗痛风有帮助。1.车前子30克(布包),用沸水沏泡30分钟后代茶频频内服。2.百合60克,薏苡仁60克,梗米60克,洗净后放锅中,加水适量,文火熬煮成粥服食,每日早晚各一次。
 
下期敬请关注全生讲中医 (16)—失眠的中医防治. 更多全生讲中医, 敬请访问卢全生中西医结合博士的网站www.wholelifeherb.com,或直接拨打中文热线电话301-919-9898, 301-340-7682约诊. 全生中医针灸医疗中心地址:  416 Hungerford Dr, Suite 215, Rockville, MD 20850 (1个街区到Rockville地铁站,免费停车). 9801 Georgia Ave, Suite 337, Silver Spring, MD 20902 (2分钟走到Forest Glen 地铁站,免费停车).
 

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