《痹证20140211.pptVIP

Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 一、概述 1.定义 痹证是由于风、寒、湿、热等邪气，痹阻经络，气血运行不畅，引起筋骨、关节、肌肉等处发生疼痛、重着、酸楚、麻木，或关节屈伸不利、僵硬、肿大、 变形等症状的一种疾病。 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 2.源流 (1)《内经》对本病的病因、证候分类及其演变等都有详细地论述。 病因方面——感受风寒湿邪 分类——行痹、痛痹、着痹三类 五因痹，五体痹，五脏痹 治疗 预后方面——五体痹复感于邪，内舍于脏腑 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. （2）《金匮要略》称本症为“历节” （3）巢元方强调体虚感邪是引起痹证的主要因素 《诸病源候论·风湿痹候》“由血气虚，则受风湿，而成此病。” （4）唐代的《千金要方》、《外台秘要》等书，收载了较多的治疗痹证的方剂，治疗方法也更加丰富。如灸法、酒药、膏摩等 独活寄生汤 （5）朱丹溪称为“痛风” （6）明清医家对痹证的治疗各有发挥，丰富了证治内容 《医宗必读·痹》 清·叶天士对痹久不愈者，有“久病入络”之说 王清任强调瘀血在痹证的发病中起着重要的作用 2.源流 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 风湿性关节炎、类风湿性关节炎，反应性关节炎、肌纤维组织炎、强直性脊柱炎、痛风、坐骨神经痛，肌纤维织炎、增生性骨关节炎等。 3.范围 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 二、病因病机 病因：外因：感受风寒湿邪 感受风湿热邪 内因：正气不足 病机：风、寒、湿、热、痰、瘀等邪气留滞肢体筋脉、关节、肌肉，经脉闭阻，不通则痛。 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 一、病因 1.外因 （1）感受风寒湿邪 风气胜者------行痹 寒气胜者------痛痹