Clinical Experience of Treating Rheumatoid Arthritis in Ma Xing Yi Gan Soup

目的：分享朴勇洙教授治疗类风湿性关节炎的临床经验。方法：通过跟师侍诊，收集相关病例，在中医对类风湿性关节炎病因病机的认识下，分析朴勇洙教授应用麻杏苡甘汤治疗类风湿性关节炎的用药辩证思路，并附医案一则予以佐证。结果：笔者在跟师学习中，认为相当数量的类风湿患者病因为卫外失司，外感风湿合邪，趁虚而入，阻滞经络，而致气血运行不利；或长居寒湿之地，寒耕暑耘，经脉久有劳伤，又复感风湿之邪，气郁于经脉，皆可致不通则痛。故以疏风散邪，温经除湿之法，运用麻杏苡甘汤辨治此类患者，疗效显著，并剖析麻杏苡甘汤加味组方依据。结论：基于以上认识，证明运用麻杏苡甘汤加味治疗类风湿性关节炎患者证实确有疗效，可供临床参考。Objective: To share Prof. Park Yong-su’s clinical experience in treating rheumatoid arthritis. Methods: By serving as an apprentice and observing the doctor, relevant cases were collected, and the doctor’s prescribing logic for using the formula “Ma Xing Yi Gan Soup” to treat rheumatoid arthritis was analyzed based on the understanding of the causes and mechanisms of rheumatoid arthritis in traditional Chinese medicine. A case is attached to support the argument. Results: During the apprenticeship, the author believes that a considerable number of rheumatoid arthritis patients are caused by failure of defense outside the body, invasion of wind and dampness by external pathogens, and obstruction of meridians, resulting in impaired blood circulation. Or, long-term residency in cold and damp places, laboring in the heat and cold of the seasons, and long-term injury to the meridians due to repeated exposure to wind and dampness pathogens can cause stagnation of qi in the meridians, leading to pain. Therefore, the method of dispersing wind and dispersing dampness and warming the meridles is used to treat such patients with the formula “Ma Xing Yi Gan Soup”, with significant therapeutic effects. The rationale for adding and modifying the formula is also analyzed. Conclusion: Based on the above understanding, it is proved that the use of the modified formula “Ma Xing Yi Gan Soup” to treat rheumatoid arthritis patients is effective, which can be used for clinical reference.