蠲痹汤加减应用治疗类风湿关节炎的研究进展

Research Progress of Treatment for Rheumatoid Arthritis with Modified Juanbi Decoction

摘要: 类风湿关节炎属于高致残慢性自身免疫病，发病率高、并发症多，单纯西医疗效欠佳，中医归为痹证，病机属本虚标实。出自《医学心悟》的蠲痹汤可祛风除湿、散寒通络，是治痹经典方。本文结合近年文献，从该病中西医发病机制、蠲痹汤配伍加减、药理机制与临床疗效展开综述。现有研究表明，蠲痹汤能调控炎症通路与细胞因子，起到抗炎护关节作用，单药或联合西药可显著改善症状、下调炎症指标。

Abstract: Rheumatoid arthritis (RA) is a highly disabling chronic autoimmune disease characterized by a high incidence rate and numerous complications, with unsatisfactory therapeutic effects achieved by Western medicine alone. In traditional Chinese medicine (TCM), this disease falls under the category of bi syndrome, and its pathogenesis manifests as root deficiency and excess in manifestation. Juanbi Decoction, originating from Insights on Medical Practice, is a classical prescription for treating bi syndrome with the efficacies of dispelling wind and eliminating dampness, dispersing cold and unblocking collaterals. Based on recent literature, this paper reviews the pathogenesis of RA from both TCM and Western medical perspectives, as well as the compatibility and modified applications, pharmacological mechanisms and clinical efficacy of Juanbi Decoction. Existing studies have demonstrated that Juanbi Decoction can regulate inflammatory signaling pathways and cytokines to exert anti-inflammatory and joint-protective effects. Used alone or combined with Western medicines, it can significantly relieve clinical symptoms and reduce inflammatory indicators.