Definitions and categories
Cold arthralgia syndrome refers to arthralgia syndrome with cold pathogen as the main factor, which is a combination of wind, cold and dampness, and cold wins, also known as joint pain and bone arthralgia. "Soul Pivot Thief Wind": "Taste hurts wet, hides in blood, and divides into meat, which lasts for a long time ... sometimes it is cold and sometimes it is warm, and the reason is closed, so it is impassable; Cold-induced arthralgia syndrome occurs when it is opened, then blood gas condenses and old evil is encountered. Chronic rheumatoid arthritis is characterized by severe joint pain, aggravated cold, and mild warmth, which belongs to the category of cold arthralgia syndrome in traditional Chinese medicine and is the most common type of arthralgia syndrome.
Etiology and pathogenesis
Li Zhenhua believes that arthralgia mainly occurs in two aspects: First, lack of healthy qi, which is mostly caused by carelessness in daily life, overwork in the house, physical weakness or long-term strain, improper work and rest, postpartum and illness. If the defensive qi is weak, the reason is not dense, and the ability to resist evil spirits is weak, evil spirits will take advantage of it, the meridians will be blocked, and the qi and blood will not run smoothly, forming arthralgia syndrome. As the saying goes, "righteousness exists within, and evil cannot be done." If evil is combined, its qi will be weak. " The occurrence of cold joint pain is mainly due to the deficiency of internal yang, which can not warm the body, especially can not resist the invasion of cold evil. The second is the joint pain caused by the invasion of external evils, wind, cold, dampness and heat. "Su Wen Bi Lun" says: "The combination of wind, cold and dampness leads to bi ... The winner of a cold is joint pain. Li Zhenhua thinks that arthralgia syndrome is caused by wind-cold-dampness, and it is one, not one. Wind-cold, rheumatism and cold-dampness did not account for 65,438+0/3 respectively, and arthralgia caused by wind-cold, dampness and heat did not account for 25% respectively. The disease is often biased towards evil, which can be biased towards wind, cold and dampness, with two qi. Cold pain and fear of cold are the main causes of cold pain, which are closely related to cold climate change. It is very painful that the body is deficient in yang, and the cold strikes, and the cold condenses blood vessels and the meridians are blocked. Therefore, Su Wen's "Babylon" said, "The cold winner is a painful comparison." "Cold is yin evil, which is easy to hurt Yang Qi. When Yang Qi didn't reach the fourth finish line, his limbs were not warm, and he felt cold in pain. When the cold gets yang heat, it dissipates, while the heat of qi and blood gets unobstructed, so the heat pain is relieved. Li Zhenhua particularly emphasized the importance of spleen-qi (Yang) in the pathogenesis of cold arthralgia syndrome, and thought that spleen governs hands and feet, while spleen-qi (Yang) deficiency can not warm hands and feet, nor can it resist the invasion of cold pathogens. After the onset, the limbs are afraid of cold, and it will get worse when it is cold. In addition, blood stasis and phlegm blocking collaterals can also cause joint pain, and prolonged retention of pathogenic factors can cause qi stagnation and blood stasis, so the treatment lies in dredging meridians, promoting qi circulation and promoting blood circulation. ?
treatment according to syndrome differentiation
Main symptoms: severe muscle pain in the joints of limbs, aggravated by cold, relieved by heat, fixed pain, light day and heavy night, even the joints can not flex, cold feeling in pain, no temperature at the end of four, pale tongue with white fur, tight pulse and so on.
Treatment: nourishing blood and activating blood, warming meridians and dredging collaterals.
Prescription: angelica 12g, chuanxiong 10g.
Radix Paeoniae Rubra 15g, Ramulus Cinnamomi 15g, Rhizoma Anemarrhenae 12g, Rhizoma Cyperi 10g, Radix Cyathulae 15g, Fructus Chaenomelis 15g, Radix Salviae Miltiorrhizae 15g, Caulis Spatholobi 30g and Caulis Spatholobi 30g.
Kusnezoff monkshood 6g
8 grams of radix aucklandiae, processed semen Strychni 1 gram.
Paoshanjia 10g
3 centipedes, Rhizoma corydalis 10g.
Licorice 3g. Decoct with water, daily 1. Addition and subtraction: the winner of cold pathogen plus 10g, dried ginger 10g, asarum 5g, cinnamon 10g.
typical case
Shen Moumou, male, 40 years old, came to the clinic on September 29, 2009. The intermittent paroxysmal pain of both knees was aggravated for 4 years, 1 week. He said that every time the weather gets cold, it gets worse. The whole body is afraid of cold, the limbs are not warm, the tongue is pale, the body is fat, the tongue has teeth marks, the tongue coating is thin and white, and the pulse is weak. Examination: The skin temperature of knee joint is normal, without swelling, and the activity is normal. Laboratory examination: ESR10mm/hour.
ASO