从“虚实”两端论治强直性脊柱炎

Treating Ankylosing Spondylitis from Both “Deficiency and Excess” Syndromes

摘要: 强直性脊柱炎是一种以慢性炎症为主要特征的难治性疾病，其病理改变主要累及骶髂关节、脊柱中轴及外周关节，并可伴随多种关节外表现。若病情进展至晚期，患者可能出现脊柱强直及结构性畸形，严重影响生活质量。目前，现代医学对其发病机制尚未完全阐明，而中医学则将其归为“痹证”范畴，并以“大偻”命名，认为其病机特点在于“本虚标实”。基于这一理论，本文围绕虚、实两大病机关键，系统探讨强直性脊柱炎的辨证论治策略，以期为临床实践提供新的诊疗思路。

Abstract: Ankylosing spondylitis is an intractable disease characterized by chronic inflammation, and its pathological changes mainly involve the sacroiliac joints, spinal mid-axis and peripheral joints, and may be accompanied by a variety of extra-articular manifestations. If the disease progresses to an advanced stage, patients may develop spinal ankylosis and structural deformity, which seriously affects the quality of life. At present, the pathogenesis of the disease has not been fully elucidated by modern medicine, while Chinese medicine has categorized it into the category of “paralysis” and named it as “big hunchback”, believing that its pathogenesis is characterized by “root deficiency with branch excess”. Based on this theory, this article focuses on the characteristics of deficiency and solidity. Based on this theory, this article systematically discusses the strategy of diagnosis and treatment of ankylosing spondylitis by focusing on the two major pathologies of deficiency and actuality, with a view to providing new diagnostic and therapeutic ideas for clinical practice.