Rheumatoid arthritis-related fatigue resulting from the pathogenesis of binding of damp, heat and stasis

CHENG Zengyu; XU Haodong; LI Da; PANG Fengtao; JIANG Wen; TANG Xiaopo

doi:10.3969/j.issn.1006-2157.2023.01.019

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Rheumatoid arthritis-related fatigue resulting from the pathogenesis of binding of damp, heat and stasis

Clinical Studies | 更新时间：2023-02-03

- Rheumatoid arthritis-related fatigue resulting from the pathogenesis of binding of damp, heat and stasis
- Journal of Beijing University of Traditional Chinese Medicine Vol. 46, Issue 1, Pages: 115-119(2023)
- 作者机构：
  
  1.中国中医科学院广安门医院　北京　100053
  2.南京中医药大学附属苏州市中医医院
- 作者简介：
  
  TANG Xiaopo, Ph.D., Chief Physician, Doctoral Supervisor.Guang’anmen Hospital, China Academy of Chinese Medical Sciences, No.5, North Line Pavilion, Xicheng District, Beijing 100053. E-mail: tangxiaopo@163.com.
- 基金信息：
  
  National Natural Science Foundation of China(81873281);National Key R&D Program(2018YFC1705203);Public Welfare Fund Projects for Central Scientific Research Institutes(ZZ15-XY-PT-11)
- DOI：10.3969/j.issn.1006-2157.2023.01.019
  CLC： R259.932
- Received：03 August 2022，
  
  Published：30 January 2023
- 稿件说明：
移动端阅览
CHENG Zengyu, XU Haodong, LI Da, et al. Rheumatoid arthritis-related fatigue resulting from the pathogenesis of binding of damp, heat and stasis[J]. Journal of beijing university of traditional chinese medicine, 2023, 46(1): 115-119.
DOI：

CHENG Zengyu, XU Haodong, LI Da, et al. Rheumatoid arthritis-related fatigue resulting from the pathogenesis of binding of damp, heat and stasis[J]. Journal of beijing university of traditional chinese medicine, 2023, 46(1): 115-119. DOI： 10.3969/j.issn.1006-2157.2023.01.019.

摘要

疲劳是类风湿关节炎(RA)的常见症状，患者自觉身心俱疲，呈“压倒性”不适，休息后难以缓解，严重影响生活质量，但临床关注度相对较低，治疗效果欠佳。中医在整体观念和辨证施治的指导下，重视患者主观症状，在降低疾病活动度的同时，有效改善RA患者疲劳症状。通过临床观察发现，湿热瘀互结是RA相关性疲劳的病机要点，不同于从虚证辨治疲劳。本文通过阐释湿、热、瘀各自的内涵及在RA相关性疲劳中的发病机制，深入分析三者的相互关系和互结病机，总结湿、热、瘀相互胶结是RA相关性疲劳的核心病机。针对此病机要点，临床确立清热除湿，活血行气为治疗大法，同时结合病邪之特性、病情之轻重，随证加减，以期为临床诊断与治疗RA相关性疲劳提供思路。

Abstract

Fatigue is a common symptom of rheumatoid arthritis (RA). Patients with RA feel physically and mentally exhausted

presenting with an "overwhelming" discomfort

which is difficult to relieve by rest and seriously affects the quality of life. However

the clinical attention to RA is relatively low and the treatment effect is insufficient. Under the guidance of holism and pattern differentiation and treatment

traditional Chinese medicine pays attention to the subjective symptoms of patients

which can effectively improve the fatigue symptom of RA patients while reducing disease activity. Clinical observation has shown that the mutual entanglement of damp

heat and stasis is key to the pathogenesis of RA-related fatigue. In contrast to deficiency syndrome differentiation and treatment of fatigue

we explain the connotations of dampness

heat and stasis and their pathogenesis in RA-related fatigue. By conducting an in-depth analysis of the relationship between the three and the pathogenesis of mutual adhesion

we conclude that the mutual adhesion of dampness

heat and stasis is the core pathogenesis of RA-related fatigue. Considering these key points

the clinical treatment method of clearing heat

and removing dampness

and promoting blood circulation and qi was established. Clinical physician could modify decoction based on syndrome differentiation according to the characteristics of the damp

heat or blood stasis

and the severity of the disease. These provide ideas for the diagnosis and treatment of clinical RA-related fatigue.

关键词

Keywords

references

SANTOS ETF , DUARTE C , DA SILVA JAP , et al . The impact of fatigue in rheumatoid arthritis and the challenges of its assessment [J]. Rheumatology (Oxford) ， 2019 ， 58 ( 5 )： 3 － 9 .

HAMMAM N , GAMAL RM , RASHED AM , et al . Fatigue in rheumatoid arthritis patients: Association with sleep quality, mood status, and disease activity [J]. Reumatol Clin(Engl Ed) ， 2020 ， 16 ( 5 )： 339 － 344 .

高蕾，史宝欣 . 类风湿关节炎疲乏评估工具的研究现状及进展 [J]. 中华风湿病学杂志， 2016 ， 20 ( 4 )： 283 － 285 .

REPPING-WUTS H , UITTERHOEVE R , VAN RIEL P , et al . Fatigue as experienced by patients with rheumatoid arthritis (RA): a qualitative study [J]. Int J Nurs Stud ， 2008 ， 45 ( 7 )： 995 － 1002 .

刘蔚翔，姜泉 . 类风湿关节炎“湿、热、瘀”病机理论探析 [J]. 中医杂志， 2020 ， 61 ( 24 )： 2148 － 2153 .

魏亭亭，秦苇，冯伟伟，等 . 类风湿关节炎患者疲劳程度与疾病活动度的关系 [J]. 浙江医学， 2021 , 43 ( 16 )： 1781 － 1784 .

DAR WR , MIR IA , SIDDIQ S , et al . The assessment of fatigue in rheumatoid arthritis patients and its impact on their quality of life [J]. Clin Pract ， 2022 ， 12 ( 4 )： 591 － 598 .

韩曼 . 中国类风湿关节炎患者报告的临床结局量表优化及应用研究 [D]. 北京：中国中医科学院， 2017 .

OVERMAN CL , KOOL MB , DA SILVA JAP , et al . The prevalence of severe fatigue in rheumatic diseases: an international study [J]. Clin Rheumatol ， 2016 ， 35 ( 2 )： 409 － 415 .

王承德，沈丕安，胡荫奇 . 实用中医风湿病学 [M]. 2版 . 北京：人民卫生出版社， 2009 ： 413 .

刘蔚翔，姜泉 . 见骨损而非独责之于肾 [J]. 中医杂志， 2019 ， 60 ( 14 )： 1198 － 1201 .

姜泉，蒋红，曹炜，等 . 475例类风湿关节炎患者中医临床证候分析 [J]. 中医杂志， 2007 , 48 ( 3 )： 253 － 255 .

李克嵩，巩勋，姜泉，等 . 863例女性类风湿关节炎患者不同证候与相关指标关系探讨 [J]. 中国中医骨伤科杂志， 2020 , 28 ( 10 )： 10 － 12 .

赵睿学 . 类风湿关节炎疲劳症状的临床调查及与中医证型相关研究 [D]. 北京：北京中医药大学， 2019 .

HOLTEN K , PAULSHUS SN , LILLEGRAVEN S , et al . Fatigue in patients with early rheumatoid arthritis undergoing treat-to-target therapy: predictors and response to treatment [J]. Ann Rheum Dis , 2022 , 81 ( 3 ): 344 － 350 .

HOLDREN M , SCHIEIR O , BARTLETT SJ , et al . Improvements in fatigue lag behind disease remission in early rheumatoid arthritis: Results from the canadian early arthritis cohort [J]. Arthritis Rheumatol ， 2021 ， 73 ( 1 )： 53 － 60 .

刘蔚翔，巩勋，姜泉，等 . 类风湿关节炎湿热与寒湿证候的病情特点分析 [J]. 中华中医药杂志， 2021 , 36 ( 2 )： 1088 － 1091 .

路志正，路洁 . 北方亦多湿续论 [J]. 中华中医药杂志， 2006 , 21 ( 9 )： 515 － 518 .

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