中醫治療伏邪所致類風濕性關節炎之病例報告

A Case Report of Hidden Evil induced Rheumatoid Arthritis with Chinese Medicine Treatment

10.7102/JTCIM.201612_14(2).0003

吳俊昌(Chun-Chang Wu)；邱冠忠(Kuan-Chung Chiou)；徐堅銘(Chien-Ming Hsu)；何宗融(Tsung-Jung Ho)

類風濕性關節炎 ； 伏邪 ； 骨痹 ； 痹證 ； 中醫 ； Rheumatoid arthritis ； Hidden evil ； Latent evil ； Bone impediment ； Impediment ； Chinese Medicine

中醫內科醫學雜誌

14卷2期（2016 / 12 / 01）

17 - 31

繁體中文

類風濕性關節炎是一種慢性的、全身性的、發炎性自體免疫疾病，常侵襲關節和關節四周的構造， 如果患者無積極治療， 此病會逐漸從周邊侵犯至近端關節而導致變形或失能，有40%的RA患者也可能侵犯其他器官， 常規治療目標以控制及防範關節之受損。本病例為46歲女性患者， 2012 年就診前類風濕性因子大於300IU， 治療思維上以伏邪致痹之概念加上現代研究之經驗，清利濕熱，扶正透邪，治療4年後， 2016年，類風濕性因子為33 IU。我們藉此病例報告以提出治療經驗， 供臨床上參考和運用。

Rheumatoid arthritis (RA) is a chronic, systemic, inflammatory autoimmune disorder of unknown etiology that primarily involves synovial joints. The disease usually progresses from the periphery to more proximal joints and results in significant locomotor disability in patients who do not fully respond to treatment. Involvement of organs not considered part of the musculoskeletal system occurs in about 40 percent of patients with RA over a lifetime of disease. The treatment of rheumatoid arthritis is directed toward the control of synovitis and the prevention of joint injury. In this case, a forty-six year-old female suffered from rheumatoid arthritis of which rheumatoid factors (RF) over 300 IU in 2012. In chinese medicine treatment strategies, we based on theory of latent evil, which induced impediment, and modem research and experience, we clear heat and disinhibit dampness, while we support right in order to dispel hidden evil. After four years treatment, in 2016, the RF value drops enormously to 33 IU. We demonstrated the experience in this case report for clinical reference and application.

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