貝賽特氏症（Behcet’s disease 又譯名：白塞氏病）是一種全身多變性的血管炎， 涉及粘膜、眼睛、皮膚等多系統器官，屬於中醫狐惑病的範疇。目前病因尚不明確， 可能與遺傳易感性、環境、病原體感染、免疫系統被激活等因素有關。目前西醫常用 類固醇、醣皮質激素、秋水仙鹼、免疫抑制劑及生物製劑等藥物來控制病情，停藥後 難免復發，且長期服用也會產生副作用。然而中醫在本病的治療上有其優勢，基於傳 統中醫理論及臨床研究實踐，結論發現此病的病位涉及肝脾腎，病性虛實夾雜，「濕、 熱、毒、瘀、虛」是主要致病因素，急性期多為濕熱蘊結之實證，緩解期多為肝脾腎 之虛證。中醫學家經綜合辨證論治，從臨床表現總結歸納出各種證型，配合證型隨病 情變化調整用方，同時善用古方並隨症加減，對於治療貝賽特氏症確有成效。本文綜 合彙整相關文獻，列舉最常見的證型就其臨床症狀、治則及方藥進行整理歸納，期望 對未來臨床治療本病提供參考並有所裨益。
Behcet’s disease (BD) is a systemic variable vasculitis, involving mucous membranes, eyes, skin and other organs, belonging to the category of Huhuo disease in Chinese medicine. The pathogenesis of BD is unclear, and it may be related tofactors such as genetic susceptibility, environment, pathogen infection and immune system activation. At present, western medicine commonly uses drugs such as steroids, glucocorticoids, colchicine, immunosuppressants and biological agents to manage symptoms. Relapse appears inevitable after drug treatment was discontinued, and long-term use also causes side effects; however, Traditional Chinese Medicine (TCM) has advantages in the treatment of BD. Based on TCM theories and clinical research practice, it is concluded that the disease location involves the liver, spleen and kidney, and is a vacuity-repletion complex. Dampness, heat, poison, static blood, and deficiency are the main pathogenic factors. The acute stage is mostly a repletion pattern of accumulation of damp-heat, and the remission stage is mostly a vacuity pattern of liver, spleen and kidney. After comprehensive pattern identification and treatments, TCM experts have summarized the various pattern types from the clinical manifestations, adjusted the prescriptions with the changes of the pattern types and used ancient prescriptions that are replaced according to the symptoms. The above methods are indeed effective for the treatment of BD. This article surveys the relevant literature, lists the most common pattern types and summarizes their clinical symptoms, treatments and prescriptions, and hopes to provide a reference and benefit for future clinical treatment of BD.
Summited for publication: 2021.6.17; Accepted for publication: 2021.11.5
