1.北京中医药大学,北京市朝阳区北三环东路11号,100029
2.中国中医科学院望京医院
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收稿:2025-01-07,
修回:2025-06-03,
纸质出版:2025-08-02
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欧阳贵淑,李光宇,唐先平等.从邪伏阴分论治成人斯蒂尔病经验[J].中医杂志,2025,66(15):1604-1609.
OUYANG Guishu,LI Guangyu,TANG Xianping,et al.Treating Adult-onset Still's Disease Based on the Theory of Latent Pathogens in Yin (阴)Level[J].Journal of Traditional Chinese Medicine,2025,66(15):1604-1609.
欧阳贵淑,李光宇,唐先平等.从邪伏阴分论治成人斯蒂尔病经验[J].中医杂志,2025,66(15):1604-1609. DOI: 10.13288/j.11-2166/r.2025.15.015.
OUYANG Guishu,LI Guangyu,TANG Xianping,et al.Treating Adult-onset Still's Disease Based on the Theory of Latent Pathogens in Yin (阴)Level[J].Journal of Traditional Chinese Medicine,2025,66(15):1604-1609. DOI: 10.13288/j.11-2166/r.2025.15.015.
以伏邪理论为指导,认为成人斯蒂尔病的基本病机是邪气深伏阴分,发病以气阴两虚为本,湿热痰瘀为标,由客邪引动阴分伏邪而发。治疗以养阴透热为关键治法,提出清化湿热、逐邪外泄,清透伏邪、透邪达表,扶正固本、益气养阴的治疗思路。临证以青蒿鳖甲汤为基础方以养阴透热,在此基础上常灵活配伍特色药对,青蒿-地骨皮滋阴清热以加强清虚热之力,鳖甲-徐长卿滋阴活血、通络散结,独活-牡丹皮祛风活血、化湿通络,清温并举、气血同调,穿山龙-地肤子化瘀祛痰、搜剔伏邪。
Guided by the theory of latent pathogens, it is believed that the basic pathogenesis of adult-onset Still's disease is the latent pathogens in the deep
yin
level. The onset of the disease is fundamentally characterized by the deficiency of both
qi
and
yin
as the root, with dampness, heat, phlegm, and blood stasis as the branch, which triggered by intruding pathogens activate the latent pathogens in
yin
level. The treatment focuses on nourishing
yin
and dispersing heat as the key therapeutic method. It is proposed that clearing and resolving dampness-heat, expelling pathogens outward, di
spersing the latent pathogens, reinforcing healthy
qi
and consolidating the root, boosting
qi
and nourishing
yin
as treatment idea. In clinic,
Qinghao Biejia Decoction
(青蒿鳖甲汤) could be used as the basic formula, and modified with characteristic herb pairs such as Qinghao (
Artemisia annua
) - Digupi (
Lycium chinense
) to enrich
yin
and clear heat, and enforce the power of clearing deficient heat; Biejia (
Lawsonia inermis
) - Xuchangqing (
Vincetoxicum mukdenense
) to enrich
yin
and activate blood, unblock the collaterals and dissipate masses; Duhuo (
Angelica biserrata
) - Mudanpi (
Paeonia × suffruticosa
) to dispel wind and activate blood, resolve dampness and unblock the collaterals, so as to clear and warm simultaneously, and regulate
qi
and blood at the same time; and Chuanshanlong (
Dioscorea nipponica
) - Difuzi (
Bassia scoparia
) to dissolve stasis and dispel phlegm, explore and dispel latent pathogens.
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