1.Diagnostic criteria
Refer to the 2009 American College of Rheumatology/European League Against Rheumatism rheumatoid arthritis diagnostic criteria.
2.TCM diagnosis and treatment
(1) Wind-cold damp paralysis.
(1) Wind-cold damp paralysis: Main evidence: pain in the joints of the limbs and painful, unfavorable repositioning. In the case of wind paralysis, the pain is wandering, or there is a fear of wind and fever, etc., the moss is thin and white, the pulse is floating and slow; in the case of cold paralysis, the pain in the joints of the limbs is severe, the pain is fixed and does not move, it is aggravated by cold, the pain is reduced by heat, the pain in flexion and extension is severe, the movement is limited, the bones are cold, the moss is white, the pulse is floating and tight or sinking; in the case of damp paralysis, the joints of the limbs are heavy and sore, the joints are swollen, the skin is numb, it is aggravated on rainy days, it is good to press and rub. The coating is white and greasy, and the pulse is moist and slow.
Treatment: dispel wind and dispel cold, warming the meridians and opening the veins, and relieving paralysis by dampness.
Remedies: Add and subtract from Releasing Palsy Tang.
For those who are windy, combine with Fangfeng Tang plus or minus; for those who are cold, combine with Wutou Tang plus or minus; for those who are damp, combine with Coix Seed Soup or Kidney Dressing Soup plus or minus.
(2) Heat paralysis of wind-dampness
Main symptoms: Rapid onset, or wandering arthralgia, with red, swollen and hot joints, painful and untouchable, tense tendons and veins, light day and heavy night, slightly relieved by cold, aggravated by heat. The tongue is red, the tongue coating is yellowish or thin yellow, and the pulse is stringy.
Treatment: Clearing heat and clearing the channels, dispelling wind and winning dampness.
Direction: Clearing heat and promoting circulation, dispelling wind and overcoming dampness.
(3) Qi and blood deficiency
Main symptoms: lingering joint pain, vague pain, pale complexion, fatigue, thin white tongue coating, sunken pulse.
Treatment: Benefit qi and nourish blood, remit paralysis and promote circulation.
Radix: Huangqi Gui Zhi Wu Wu Wu Tang with Si Wu Tang.
(4) Liver and kidney deficiency
Main symptoms: paralysis that does not heal over time, unfavorable joint flexion and extension, thin muscles, soreness and weakness of the waist and knees, numbness of the joints, especially on rainy days, pale tongue with white fur or petechiae, sunken and thin or astringent pulse.
Treatment: Nourishing the liver and kidney, soothing the tendons and opening the channels.
Remedy: Duluxiaosheng Tang plus or minus.
(5) Paralysis with phlegm and stagnation
Main manifestations: prolonged paralysis, painful fixed limb joints, unfavorable flexion and extension, enlarged joints, stiffness and deformation, constriction of tendons and veins, tightness of elbows and knees, dull and sallow complexion, dark red tongue, white greasy moss, stringent and astringent pulse.
Treatment: Removal of phlegm and blood stasis, releasing paralysis and clearing collaterals.
Remedy: Add and reduce Shuanghe Tang.