1. Deficiency of qi and blood in liver, spleen and kidney is the cause, and phlegm and blood stasis are the target of the disease.
Rheumatoid arthritis has a lingering condition and a long course. First of all, its pathological factors are mainly congenital endowment deficiency, liver and kidney deficiency, yang deficiency, unclear pathogenesis and unstable external defense, which make wind, cold and dampness enter meridians and joints and hinder the operation of qi and blood. As Su Wenbi said, "those who have been ill for a long time must be confined to their combination" and "those who have endless bone arthralgia and feel evil must be confined to their kidneys." The kidney governs the bones, the main tendons of the liver, and the joints of bones and muscles, which are nourished by the essence and blood of liver and kidney. Pathogens invade the bones and muscles, tendons hurt the liver, and bones hurt the kidney. Liver and kidney injury leads to malnutrition of bones and muscles, muscle insufficiency, acute joint pain, unfavorable flexion and extension, and even serious dysfunction such as muscle weakness, muscle contraction, bone injury, joint deformity and stiffness, and difficulty in movement. Spleen governs muscles, transports water and dampness, and spleen deficiency leads to endogenous phlegm and dampness, which interweaves with phlegm and causes catastrophe. Severe swelling and joint effusion can be seen in muscle meridian, so deficiency of blood in liver, kidney and spleen is the main internal cause of this disease. As a result of persistent illness and recurrent attacks, exogenous pathogens, pathogenic wind, cold, dampness and heat will attack repeatedly, penetrate into tunnels and epiphyses, and the meridians are unfavorable, resulting in blood stasis, wet turbidity and viscosity, phlegm and blood staying in the joints, blocking the meridians, and forming joint stiffness, swelling and deformity, which is difficult to heal for a long time. Therefore, the disease is based on deficiency of liver, spleen and kidney, marked by phlegm and blood stasis due to wind, cold, dampness and heat, and its pathological mechanism is obstruction of meridians, qi stagnation and blood stasis. The pathological mechanism can be summarized as "deficiency, evil and blood stasis".
2. Nourishing liver and kidney and regulating spleen and stomach qi and blood is the fundamental solution.
Because the disease is stubborn and has a long course of disease, the etiology is deficiency of liver, spleen and kidney, phlegm and blood stasis, meridian obstruction, qi stagnation and blood stasis as pathology, so the treatment is mainly to nourish liver and kidney, tonify qi and blood, regulate spleen and stomach, supplemented by clearing away heat and toxic materials, eliminating dampness and turbidity, removing blood stasis and resolving phlegm, searching wind and removing evil, dredging arthralgia and relieving pain. Rhizoma Curculiginis, Herba Epimedii, Ant, Eucommiae Cortex, Semen Cuscutae, and Achyranthis Radix are mainly used for tonifying kidney, and are selected and added according to deficiency of both yin and yang; Fructus Ligustri Lucidi and Carapax et Plastrum Testudinis are added for yin deficiency, and Radix Aconiti Lateralis, Cortex Cinnamomi and Fructus Psoraleae are added for yang deficiency; Radix Rehmanniae Preparata, Radix Angelicae Sinensis, Radix Paeoniae Alba, Fructus Chaenomelis, Caulis Spatholobi and Herba Taxilli are suitable for nourishing liver. Astragalus membranaceus, Atractylodes macrocephala, Codonopsis pilosula and Dioscorea opposita are selected for strengthening spleen and benefiting qi. If the liver, spleen and kidney are healthy together, arthralgia is self-inflicted; Radix Clematidis, Scorpio, Zaocys, Ramulus Cinnamomi, etc. Ji Fang, Coicis Semen, Gypsum Fibrosum, Rhizoma Anemarrhenae, Rhizoma Atractylodis and Cortex Phellodendri should be used for clearing away heat and toxic materials, and eliminating dampness and turbidity. Angelica sinensis, Ligusticum Chuanxiong, Salvia Miltiorrhiza, Spatholobus suberectus, Semen Sinapis Albae, Bombyx Batryticatus, etc. Used for removing blood stasis, resolving phlegm and dredging collaterals; Caulis Trachelospermi, Caulis Piperis, Caulis Sinomenii for activating collaterals and relieving pain, and even Moschus, Semen Strychni, Scolopendra, Scorpio, Asari, etc.
After years of clinical screening, the self-made Fuzheng Juanbi decoction has satisfactory curative effect. Prescription: Radix Astragali 30g, Ginseng 10g, Atractylodis Macrocephalae 12g, Angelica sinensis 10g, Rhizoma Curculiginis 10g, Semen Cuscutae 30g, Herba Epimedii 10g, Radix Paeoniae Alba 15g, Caulis Spatholobi 30g and Radix Clematidis 60g.
Astragalus membranaceus is a good medicine for invigorating qi, and it can replenish vitality together with ginseng. Atractylodes macrocephala strengthens spleen and benefits qi, and spleen deficiency and dampness are abundant. Cuscuta chinensis and Erxian decoction warm kidney and strengthen supervision; Guizhi warms meridians to dispel cold, runs qi and blood, opens and closes depression, and promotes the rapid elimination of evil toxin; Paeonia lactiflora and camp astringe yin and nourish tendons; Angelica sinensis and Spatholobus suberectus nourish blood and promote blood circulation, dredge collaterals and relieve pain; Lingxian is an essential medicine for expelling wind and removing dampness, dredging collaterals and relieving pain. Self-defense, dehumidification, dredging collaterals and relieving pain; Ginger and jujube harmonize camp, health and blood; Roasted licorice strengthens bones and muscles, increases muscles, doubles strength, and can also ease medicinal properties and reconcile various drugs. The whole prescription has the effects of warming liver and kidney, invigorating spleen and benefiting qi, dispelling cold, expelling wind and removing dampness, removing blood stasis, dredging collaterals and relieving pain.
Addition and subtraction: two centipedes and 3g scorpions are added for patients with severe pain. When the wind is strong, add Radix Saposhnikoviae, Zaocys, Notopterygii Rhizoma and Radix Angelicae Pubescentis 65438±00g；; In cold season, 65438 00 grams of cooked aconite, 6 grams of Asari, and even 65438 00 grams of prepared Radix Aconiti and prepared Radix Aconiti Kusnezoffii are added; Adding Rhizoma Atractylodis 12g, Coicis Semen 30g, Cortex Erythrinae 10g, and Fructus Chaenomelis10g; Adding gypsum 30g, Rhizoma Anemarrhenae10g, Radix Gentianae Macrophyllae10g, Lumbricus10g, and Caulis Trachelospermi10g; For kidney deficiency, 30g of shredded paper and antler cream15g are added; Chronic obstinate arthralgia, adding leech, nidus Vespae, pangolin scales, Eupolyphaga Seu Steleophaga, and Millettia Manis 65438 00 grams each; For those with unfavorable flexion and extension, Lycopodium 15g, Fructus Lipuidambaris 12g and Fructus Chaenomelis 12g are added. For those who are numb, Bombyx Batryticatus, Rhizoma Pinelliae, Rhizoma Arisaematis and Semen Sinapis Albae are added with 65438+/-00g each; For patients with erythema and nodules, Cortex Moutan 10g, Radix Salviae Miltiorrhizae 20g, Fructus Gleditsiae Abnormalis 10g and Manicure10g should be added; Radix Cyathulae and Radix Angelicae Pubescentis are added for lower limb pain; For shoulder and arm pain, Radix Clematidis and Curcuma Rhizome are added; Radix Puerariae and Notopterygii Rhizoma are added for neck pain; For patients with low back pain, add Ciji and cornu Cervi Degelatinatum to facilitate menstruation.