关键词： 风湿性膝关节炎；中药熏洗；隔蒜炎；中药内服

36 Cases of Rheumatic Gonitis Treated by Herbal Fumigation and Steaming,

Garlic Moxibustion and Oral Administration of TCM Herbs

He Shenzhang

Dachuan,Sichun,China635000

36 cases of rheumatic gonitis received the treatment of herbal fumigation and steaming, garlic moxibustion and oral administrtion of TCM herbs. Some herbs were prescribed to decoct toge ther and smoke of the hot steam from the herbal decoction was used to heat the affected area. In addition, A 2mm think slice of raw garlic was placed on the Xiyan Piont of the affected knee for moxibustion.The Wu Tou Decoction with plus or minus was also administrated orally. The course of treatment was 10 days. The results from the treatment showed that 32 cases were cured, 2 markedly improved and 1 improved , but one had the ineffective result, with the total effective rate being 97%. The results also showed that 11 cases were cured with one course of treatment, 7 with two courses and 14 with three courses.

Key Words:rheumatic gonitis;fumigation and steaming garlic moxibusion

近年来，笔者采用中医综合疗法治疗风湿性膝关节炎36例，疗效较好。

1临床资料

本组36例中，男17例，女19例；14～30岁20例，31～50岁7例，51～69岁9例；病程最短3天，最长3周，平均18天。双侧患病3例，单侧患病34例；患者均有居室潮湿或工作环境潮湿史。曾经中医或西医治疗无效。抗“O”均＞500U，类风湿因子阴性，多数血沉增快，少数白细胞升高。

2治疗方法

2.1中药熏洗法

药物组成：鲜石菖蒲、陈艾叶、透骨草、八角枫叶等适量。每日1剂，用水煎沸，用大盆盛装乘热熏洗患膝。熏洗以出汗为度。中药熏洗每日2次，10日为1疗程。

2.2隔蒜灸

熏洗后，用独头紫皮蒜1枚，切成片状，放在患侧膝眼穴，再将艾绒搓成柱状放在蒜皮上灸。待艾柱燃至皮肤灼热不可忍时去蒜片及艾柱。隔蒜灸每日2次，10日为1疗程。

2.3中药内服

以乌头汤为基本方：

麻黄 9g制川乌6g(先煎30min)

芍药15g黄芪20g炙甘草9g

血虚加当归，气虚重用黄芪加乌药；食少纳差加白术、茯苓、焦神曲、焦麦芽、焦山楂；阴虚发热者增玄参，枸杞子，阳虚加服肾气丸、左归丸。

日1剂，水煎服，10日为1个疗程。

若患者高热，膝关节红肿疼痛剧烈，可配合使用抗生素治疗。

3疗效观察

3.1疗效标准

痊愈：临床症状消失，功能恢复正常；

显效：临床症状减轻，功能基本恢复；

有效：临床症状减轻，功能活动尚可；

无效：临床症状、功能无改善。

3.2治疗结果

痊愈32例，显效2例，有效1例，无效1例，总有效率97.2%．1个疗程治愈11例，2个疗程治愈者7例，3个疗程治愈者14例。

4体会

风湿性膝关节炎，属祖国医学“痹证”范畴，其病机多为风、湿、寒三邪侵入人体，阻滞经络关节，气血运行不畅而致关节疼痛，功能障碍。熏洗方具有温经散寒通络导滞的作用，用熏洗的方法可更好的发挥药力。隔蒜灸膝眼穴更具开窍通痹、温通脉络作用。配合乌头汤以散寒祛湿，除痹止痛。

1999-09-25收稿