Arthralgia syndrome
【Summary】
Arthralgia
syndrome is caused by blockage of channels and qi and blood flowing unsmoothly
due to invasion of exogenous pathogenic wind, cold, dampness and heat, marked by
pain, numbness, a heavy feeling, swelling, incapability of flexing and extending
or even a feeling of burning heat in muscles, bones and joints. Zhang Zhong jing
argued with wind-dampness syndrome, damparthralgia, severe and migratory
arthralgia; there are also illness names such as li jie feng, bai hu feng, bai
hu li jie feng, tong feng,(severe and migratory arthralgia),he xi feng, gu chun
feng, (arth- roncus of knee )in later generation. They all belong to the
category of arthralgia syndrome .
Huang Di Nei Jing divides arthralgia syndrome into wind arthralgia, arthralgia aggravated by cold, damp arthralgia according to the invasive degree of wind, cold, dampness pathogen. Arthritis of heat type is also added to it in late generation. In addition, it is called arthralgia of five body constituents (bone, vessel, tendon, muscle, and skin ) on account of the location of the illness and the season when exogenous pathogen invades the body. If arthralgia of five body constituents has delayed for a long time and can not be get rid of, it will involve with five viscera and turn into syndromes caused by obstructed qi flow in the five Zang-organs. For example, obstruction of heart-qi often seen in clinic, is marked by blocked pulse, restlessness and severe palpitation dyspnea due to suddenly rising of abnormal qi, dry sensation in pharynx and frequent eructation, a feeling of fear due to upward adverse flow of qi; “obstruction of the kidney channel is manifestated as inability to stand up straightly as if the function of heels is replaced by the sacral bone , and humped thoracic vertebrae seeming higher than head”, etc. It is of great significance that we identify the clinic characteristics of arthralgia syndrome and know of progreeion of it.
In western medicine, the diseases such as rheumatic arthritis, rheu- matoid arthritis, bony arthritis. sciatica, periarthritis humeros- capularis, gout, and so on can also refer to this syndrome for diagnosis and treatment based on pathogensis obtained through differentiation of symptoms and signs.
【Etiological factors and morbid
mechanism】
Arthalgia syndrome is mainly caused by invasion of wind,
cold, dampness, heat pathogen on
the condition of deficiency of vital-qi. The brief explanation is as follows:
1.Deficiency of vital-qi causing failure of superficial-qi protecting the body against diseases, striae of skin ,muscles and viscera being loose will lead to exogenous pathogen invading the body and retaining in the interspaces of muscles, tendons and channels due to dificiency of vital-qi, so that normal flow of qi and blood is obstructed .Deficiency of vital-qi is related inmitately to innate weakness of the body, imbalance between work and test, shortness of physical exercises, menstruation and porspartum for female.
2.Pathogenic wind, cold and dampness invading the body, or
infecting pathogenic heat. or wind, cold and dampness pathogen retained for a
long time turning into heat .If it is warm, a person who falls asleep in the
wind after sweating will easily infect wind pathogen; if it is cold and the
earth is frozen, a person will easily infect wind and cold pathogen; if a person
has lived in damp place for a long time or a person catches in the rain, he will
easily infect dampness pathogen; wind and heat pathogen, in combination with
dampness pathogen can invade the body; if arthritis of heat type delays for a
long time and stagnation of pathogen converts into heat, wind, cold, dampness
and heat pathogen can invade the body.
Deficiency
of vital-qi and invasion of exogenous
pathogen are the etiological factors of arthralgia syndrome. Concretly speaking,
invasion of exogenous pathogen is a external factor and deficiency of vital-qi
is a basic internal factor during the occurrence of the disease. Only when the
former combines with the latter, will the disease occur. In the case of
preponderance of yang-qi, hyperactivity of fire due to yin deficiency or
infectation of wind, dampness and heat pathogen, arthritis of heat type will
easily occur. In the case of deficiency of yang-qi or infectation of
wind-cold-dampness pathogen, arthritis of heat type will easily occur. The
former can interchange with the latter under the specific condition. Besides,
wheather arthritis of heat type or arthralgia due to wind-cold-dampness lasts
for a long time, blood and qi will stagnate in channels and collaterals which
causes the syndrome of phlegm accumulating with stagnant blood, marked by
ecchymosis, subcutaneous nodule and peri-articular nodule or joint deformity,
etc. Moreover, because of retention of pathogenic qi in the channels, stagnated
blood can,t be get rid of so that fresh blood can,t be
produced, which leads to impairment of qi and blood, even the syndrome of
deficiency of the liver and kidney due to the joints being lack of movement.At
last, because arthralgia syndrome has delayed for a long time, together with
invasion of exogenous pathogen, the arthralgia of five body constituents will
convert into syndromes caused by obstructed qi flow in the five Zang-organs,
among which obstruction of the heart-qi and obstruction of the kidney channel
often occur.
pathogenesis of arthralgia syndrome
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