黎裕朝主任医师运用通阳法治疗类风湿关节炎思路及临床经验总结

Summary of Chief Physician Li Yuchao’s Conceptual Approach and Clinical Experience in Treating Rheumatoid Arthritis with the Tongyang Method

摘要: 类风湿关节炎作为临床高发的顽固性自身免疫性疾病，迁延难愈且致残风险较高，现代医学尚无根治方案。中医将本病归属于痹证范畴，核心病机多以阳气阻滞、阴邪羁留、气血不通为主，通阳法为临床辨治本病的核心有效治法。本文基于临床侍诊学习所得，系统梳理黎裕朝主任医师运用通阳法治疗类风湿关节炎的诊疗经验，归纳辛温通阳、祛湿通阳、温补肾阳、温血通阳四类特色治则，搭配多则临床典型病例与其他疗法辨析以验证方药疗效。

Abstract: Rheumatoid arthritis, as a highly prevalent and refractory autoimmune disease in clinical practice, is characterized by prolonged duration, difficulty in cure, and a high risk of disability; modern medicine currently lacks a definitive cure. Traditional Chinese Medicine categorizes this condition under the syndrome of Bi (bi zheng), with its core pathogenesis primarily involving stagnation of yang qi, retention of yin pathogens, and obstruction of qi and blood circulation. The Tongyang method constitutes the central and effective therapeutic approach for clinical management of this disease. Based on clinical observations, this article systematically summarizes Chief Physician Li Yuchao’s diagnostic and therapeutic experience in treating rheumatoid arthritis using the Tongyang method, identifying four distinctive therapeutic principles: warming-warming to promote yang circulation, eliminating dampness to promote yang circulation, tonifying kidney yang, and warming blood to promote yang circulation. These principles are supported by numerous typical clinical cases and comparisons with other therapies to validate the efficacy of these prescriptions.