[1]吴海娟,倪震博,雷海桃,等.基于“久病入络”理论探讨田雪梅针药结合治疗痛风性关节炎的经验[J].西部中医药,2026,39(02):5-8.[doi:10.12174/j.issn.2096-9600.2026.02.02]
　WU Haijuan,NI Zhenbo,LEI Haitao,et al.Professor Tian Xuemei’s Experience in the Treatment of Gouty Arthritis by Combining Needle Knife and Medicine Based on the Theory of "Prolonged Illness Invading the Collaterals"[J].Western Journal of Traditional Chinese Medicine,2026,39(02):5-8.[doi:10.12174/j.issn.2096-9600.2026.02.02]
点击复制

基于“久病入络”理论探讨田雪梅针药结合治疗痛风性关节炎的经验()

《西部中医药》[ISSN:2096-9600/CN:62-1204/R]

卷:
39
期数:
2026年02期
页码:
5-8
栏目:
陇上医家
出版日期:
2026-02-15

文章信息/Info

Title:
Professor Tian Xuemei’s Experience in the Treatment of Gouty Arthritis by Combining Needle Knife and Medicine Based on the Theory of "Prolonged Illness Invading the Collaterals"
作者:
吴海娟1, 倪震博1, 雷海桃1, 马起虹2, 高韵奇3, 杨静1, 王海东1, 吕柳4, 田雪梅,,,
1.甘肃省中医院，甘肃 兰州 730050
2.甘肃中医药大学，甘肃 兰州 730000
3.庆阳市人民医院，甘肃 庆阳 745000
4.北京中医药大学东直门医院，北京 101121
Author(s):
WU Haijuan1, NI Zhenbo1, LEI Haitao1, MA Qihong2, GAO Yunqi3, YANG Jing1, WANG Haidong1, LYU Liu4, Director: TIAN Xuemei,,,
1.Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou 730050, China
2.Gansu University of Chinese Medicine, Lanzhou 730000, China
3.Qingyang People’s Hospital, Qingyang 745000, China
4.Dongzhimen Hospital of Beijing University of Chinese Medicine, Beijing 101121, China
关键词:
痛风性关节炎; 久病入络; 针刀; 针药结合; 田雪梅
Keywords:
gouty arthritis; prolonged illness invading the collaterals; needle knife; the combination of acupuncture and medicine
分类号:
R259
DOI:
10.12174/j.issn.2096-9600.2026.02.02
文献标志码:
A
摘要:
基于“久病入络”理论，探讨田雪梅针药结合治疗痛风性关节炎（gouty arthritis，GA）的经验。田雪梅立足叶天士“久病入络”之论，认为GA病机为“脾肾亏损为本，湿热痰瘀痹阻为标”，久病致湿浊瘀毒由经入络，缠结络脉而成癥积（痛风石）；GA的治法以“针药结合”为纲，中药内服承“寓通于补，培补脾肾”之旨，辛通开痹、化瘀涤痰、渗浊利窍、祛邪通络，辅四君子汤、六味地黄丸健脾益肾固本，暗合“疏其血气，令其调达”之意；针刀分期施治，急性期疏泄阳络郁火，慢性期破散阴络癥积，迁延期通行督脉振阳，以取“松筋解结、给邪出路”之功。针药协同，外治速通有形瘀结，内治温补无形虚损，内外共调，标本同治，终使“浊毒去而络道通，脾肾复而顽痹蠲”。
Abstract:
Based on the theory of "prolonged illness invading the collaterals", we discussed professor Tian Xuemei’s experience in treating gouty arthritis (GA) by the combination of needle knife and medicine. Professor Tian considerers that the pathogenesis of GA lies in "the depletion of spleen and kidney as the root cause, damp-heat, phlegm, stagnation obstructing as the symptoms", damp-turbidity, stagnation and toxin caused by prolonged illness entered from the meridians to the collaterals, transforming into gouty tophi; therapeutic method for GA adopted "the combination of needle knife and medicine" as the outline, "dredging the collaterals by tonifying, cultivating and invigorating spleen and stomach" was taken as the gist for oral TCM by removing arthralgia with pungent and warm medicinals, resolving the stagnation and removing phlegm, draining turbidity and opening the orifices, removing the pathogen and unblocking the collaterals, Sijunzi Tang and six-flavored Dihuang pills were added to invigorate spleen, benefit kidney and consolidate the foundation, conforming to the meaning of "restoring balance through the regulation of Qi and blood circulation"; needle knife is used for phased therapies, releasing the stagnated fire in Yang collaterals at acute stage, removing the masses in the Yin collaterals at chronic stage, and unblocking the governor meridian and boosting Yang at subacute stage, so as to achieve the effects of "relaxing the tendon and unknotting, finding the outlet for the evils". The combination of needle knife and medicine could remove the masses, and benefit the deficiency, regulating the external and internal, treating the root causes and symptoms simultaneously, consequently "removing turbid-toxin to dredge the collaterals, benefiting the spleen and kidney to treat the arthralgia".

相似文献/References:

[1]柴守范,赵晓丽.论“久病入络”与“温邪入络”[J].西部中医药,2013,26(11):41.
　CHAI Shoufan,ZHAO Xiaoli.On "Prolonged Illness Invading the Collaterals" and "Warm Pathogen Invading the Collaterals"[J].Western Journal of Traditional Chinese Medicine,2013,26(02):41.
[2]柳永明,雷宁波,董林,等.藏药内服外敷治疗痛风性关节炎40例[J].西部中医药,2014,27(04):57.
　LIU Yongming,LEI Ningbo,DONG Lin,et al.Treatment for 40 Cases of Gouty Arthritis by Tibetan Medicine for Oral Administration and External Use[J].Western Journal of Traditional Chinese Medicine,2014,27(02):57.
[3]黄嘉年,光波,幸程涛.自拟痛风要方合如意金黄散外敷治疗湿热蕴结型急性痛风性关节炎临床观察[J].西部中医药,2026,39(09):142.[doi:10.12174/j.issn.2096-9600.2026.09.27]
　HUANG Jia?nian,GUANG Bo,XING Chengtao.Clinical Observation on Self-Formulated Gout Prescription Combined with External Application of Ruyi Jinhuang Powder in the Treatment of Acute Gouty Arthritis of Damp-Heat Accumulation Type[J].Western Journal of Traditional Chinese Medicine,2026,39(02):142.[doi:10.12174/j.issn.2096-9600.2026.09.27]
[4]陈明歌,刘松江.从“初病在经，久病入络”论治胃癌[J].西部中医药,2022,35(11):108.[doi:10.12174/j.issn.2096-9600.2022.11.21]
　CHEN Mingge,LIU Songjiang.Discussion on Treating Gastric Cancer from "Early Disease in the Meridian, Chronic Disease Transforming to Collaterals"[J].Western Journal of Traditional Chinese Medicine,2022,35(02):108.[doi:10.12174/j.issn.2096-9600.2022.11.21]
[5]张乘源,尹纪光,吴伟山,等.基于“久病入络”理论论治股骨头坏死[J].西部中医药,2023,36(04):39.[doi:10.12174/j.issn.2096-9600.2023.04.09]
　ZHANG Chengyuan,YIN Jiguang,WU Weishan,et al.Treatment of Osteonecrosis of the Femoral Head Based on the Theory of "Pathogen Intruding into Collateral in Protracted Disease"[J].Western Journal of Traditional Chinese Medicine,2023,36(02):39.[doi:10.12174/j.issn.2096-9600.2023.04.09]
[6]王玉天,朱跃兰,席雅婧.基于网络药理学探讨“土茯苓-川牛膝”药对治疗痛风性关节炎的作用机制[J].西部中医药,2023,36(06):54.[doi:10.12174/j.issn.2096-9600.2023.06.13]
　WANG Yutian,ZHU Yuelan,XI Yajing.The Mechanism of Treating Gouty Arthritis with Couple Medicines of "Tufuling-Chuanniuxi" Based on Network Pharmacology[J].Western Journal of Traditional Chinese Medicine,2023,36(02):54.[doi:10.12174/j.issn.2096-9600.2023.06.13]

备注/Memo

备注/Memo:
国家重点研发计划项目（2022YFC3501202）；国家中医药管理局高水平重点学科建设项目（国中医药人教函〔2022〕226号）；甘肃省针刀医学产学研合作平台建设项目（2022-3-33）；田雪梅甘肃省名中医传承工作室建设项目（甘中医药发〔2024〕7号）。吴海娟（1990—），女，硕士学位，主治医师。研究方向：风湿免疫疾病的中西医结合诊治。
更新日期/Last Update: 2026-02-15