痛风性关节炎是一种由于血尿酸水平过高，导致尿酸结晶沉积在关节内而引起的炎症性疾病。邵敏教授在传承中医 经典理论基础上，结合多年临床实践心得，提出痛风性关节炎多见于脾胃虚弱之人，因感受风、寒、湿等邪气，以湿邪为 主要病理基础，化热、成痰、化瘀，壅塞经脉，脉络不通，热蒸湿阻，而致痛风。故其中医病机可概括为：脾虚为本，诸 邪为标；湿浊痰瘀为患，痹阻下肢关节；脾虚湿滞为其核心病机。痛风性关节炎的治疗原则需秉承整体观念，标本兼治， 补泻并用，以健脾祛湿为根本治法，兼以温化、清热、祛痰、行瘀、除痹止痛。临床治疗脾虚湿阻型痛风性关节炎可运用 参苓白术散加减以健脾祛湿，除痹止痛。

Gouty arthritis is an inflammatory disease characterized by the deposition of urate crystals in joints induced by elevated serum uric acid levels. Based on classical theories of traditional Chinese medicine （TCM） and years of clinical practice，Professor Shao Min proposes that gouty arthritis usually develops in the individuals with spleen-stomoach deficiency. The pathogenesis involves the invasion of pathogenic factors such as wind，cold，and dampness， and the dampness pathogen is the primary pathological factor. The dampness pathogen is prone to transforming into heat，developing into phlegm，and inducing the formation of blood stasis，which collectively obstruct the meridians. The blockage of meridians leads to a failure of free qi-blood flow in the vessels and collaterals， which induces a condition of heat steaming and dampness obstruction， and then the gout forms. Therefore，TCM pathogenesis of gout arthritis can be summarized as：Spleen deficiency acts as the root cause and various pathogenic factors serve as the second incidental factors；dampness-turbidity，phlegm，and blood stasis are the pathological products，which obstruct the lower limb joints；spleen deficiency with dampness stagnation constitutes the core pathogenesis. The therapeutic principle for gouty arthritis should adhere to the holistic concept， addressing both root cause and incidental factors， and combining tonification and purging methods. The fundamental approach is to strengthen spleen and eliminate dampness，supplemented by warming and resolving methods， and the methods of clearing heat， expelling phlegm， removing blood stasis， and unblocking obstruction and relieving pain. For clinical treatment of gouty arthritis with spleen deficiency and dampness obstruction， modified Shenling Baizhu San can be applied to fortify the spleen， remove dampness， unblock obstruction and alleviate pain.

R259.897

广东省自然科学基金项目（编号：2021A1515010725）；广东省普通高校特色创新类项目（编号：2024KTSCX115）