林创坚教授临证发现，中老年人及脾肾功能较为虚弱的患者易患痰浊瘀阻型痛风性关节炎，临床表现以病久屡发、 关节痛明显、昼轻夜甚、局部关节变形、肌肤麻木不仁、步履艰难、筋脉拘急、屈伸不利等为主要特点，可兼见面浮足肿、 胸脘痞满、头晕耳鸣、颧红口干、腰膝酸软等表现。痰浊瘀阻型痛风性关节炎为本虚标实之证，“痰浊瘀”为病之标，“脾 肾两虚”为病之本，辨治时应重视“痰浊瘀”与脾、肾二脏之间的关系，脾肾为痰浊瘀之本；治疗时，强调标本兼治的治 疗原则，以健脾益肾、祛痰化浊、活血化瘀为主要治法，拟定补肾蠲痹益脾汤为基础方，药物组成为羌活、独活、肉桂心、 秦艽、当归、川芎、炙甘草、海风藤、桑枝、乳香、木香、盐巴戟天、桑寄生、防风、土茯苓、布渣叶、白术、法半夏、 威灵仙、佩兰。临证时，可针对不同兼症辅以健脾、宣肺、疏肝、宁心等药物。其辨治思路可为中医临床治疗痛风性关节 炎提供参考。

Professor Lin Chuangjian noticed that middle-aged and elderly individuals，as well as patients with weakened spleen and kidney function，are prone to developing gouty arthritis of phlegm-turbidity and blood stasis obstruction type. The clinical manifestations of gouty arthritis of phlegm-turbidity and blood stasis obstruction type were characterized by recurrent and prolonged episodes，marked joint pain （worse at night） ，joint deformities，numbness and stiffness of the skin，difficulty in walking， spasm of muscles， and limited joint movement，and were probably accompanied by facial and pedal edema，chest and epigastric fullness，dizziness and tinnitus，flushed cheeks and dry mouth， and soreness and weakness of the lower back and knees. Gouty arthritis of phlegm-turbidity and blood stasis obstruction type is a fundamentally-deficiency and incidentallyexcess syndrome， characterized by phlegm-turbidity-stasis as the symptomatic features， and spleen-kidney deficiency as the root cause. During syndrome differentiation， Professor Lin emphasizes the relationship between phlegm-turbidity-stasis and the zang-organs of spleen and kidneys，and considers that the dysfunction of spleen and kidneys is the root cause of phlegm-turbidity-stasis formation. During treatment， therapeutic principle of simultaneously treating the symptom and root cause was followed，primary methods of fortifying the spleen and tonifying the kidneys，removing phlegm and resolving turbidity， and activating blood circulation to resolve stasis were adopted，and Bushen Juanbi Yipi Decoction was used as the foundational prescription. Bushen Juanbi Yipi Decoction consists of the herbs of Notopterygii Rhizoma et Radix， Angelicae Pubescentis Radix， Cinnamomi Cortex， Gentianae Macrophyllae Radix， Angelicae Sinensis Radix， Chuanxiong Rhizoma， Glycyrrhizae Radix et Rhizoma Praeparata cum Melle， Piperis Kadsurae Caulis， Mori Ramulus， Olibanum， Aucklandiae Radix，salt-processed Morindae Officinalis Radix，Taxilli Herb，Saposhnikoviae Radix，Smilacis Glabrae Rhizoma， Microctis Folium， Atractylodis Macrocephalae Rhizoma， Pinelliae Rhizoma Praeparatum， Clematidis Radix et Rhizoma， and Eupatorii Herba. In clinical practice， adjunct herbs for fortifying spleen ， ventilating lung，soothing liver，or tranquilizing heart may be added based on accompanying symptoms. Professor Lin’s diagnostic and therapeutic approach will provide valuable insights for the traditional Chinese medicine management of gouty arthritis.

R259.897

广东省中医药局科研项目（编号：20252040）；第七批全国老中医药专家学术经验继承项目（国中医药人教函 〔2022〕 76 号）