基于“主客交-络病”理论探讨类风湿关节炎的病机及辨治

[中图分类号]R274 [文献标志码]A [文章编号]doi：10.3969/j.issn.1674-070X.2025.11.019

[Abstract]Rheumatoidarthritis （RA）categorzedas"B-impedimentdisorders"inTCM，ischaracterizedbyaprolongedand relapsingclinicalousethatoftenleadstojointdeformitiesanddisabilityPreviousinterpretationsofitspathogenesishavemostly beenexplainedintermsof"thestruglebetweenhealthyqiandpathogenicfactors"and"thecombineddeficiencyandexc"，but failedtofullyelucidatethcomplexandevolving natureof thediseaseprocessTakingthetheoriesof "hostguestcontention"and "colateraldisease"asthestartingpointstepaperatemptstoconstructanewtheoreticalframeworkforthepathogenesisofRA. The"host-guestcontention"theoryemphasizesthedynamic featuresofwaxingandwaningof healthyqiandpathogenicfactors，as wellastetrasformationbetwendeficiencandxce，whereast"collteraldisease”theoryrevealshepersistentpathological mechanismbywhichpathogenicfactorsostructthecolaterals，leadingtostagnationofqiandblood.Theintegrationofthesetwo theoriesprovidesasystematicexplanationofthespatiotemporalevolutionofRA，therebyuncoveringtheintrinsicpaternof transitionfromacuteinflammationtochonicrefractoryBi-impedimentdisease.Basedonthisframework，thispaperproposesa stage-basedappoachtopattrdiferentiationandtreamentofRA：intheearlystage，treatmentshouldfocusonremovingwind， eliminatingdampessaswellasunblockingandharmonizingthemeridians;inthemidlestage，itsouldemphasizeclearinghat andtransformingstasis，aswellasregulatingtheYingnutrentsandunblockingcolaterals;andinthelatestage，thepriorityshould shifttoreinforcinghealthqiandtonifingdeficiencyandunblockingcolateralshilermovingstasis.istheoreticalodelot onlydeepenstheuderstandingofRApathogenesisfromtheperspectiveofTCM，utalsoprovidesaewtheoreticalfoudatiofor itspatterndiferentiationandtreatment.ItreflectstheinnovativeintegrationofCMpathogenesistheorieswithmodernimmuno inflammatory mechanisms.

[Keywords]rheumatoidarthitis;ostguestcontention;colateraldisease;pattdiferentiatioandtreatment;inflama tion

类风湿关节炎（rheumatoidarthritis，RA）是以慢性滑膜炎为主要病理特征的系统性自身免疫性疾病，临床表现为关节红肿热痛、晨僵、关节畸形与功能障碍，严重影响患者的生活质量。（剩余10930字）