〔摘要〕 痛风是临床常见的风湿免疫性疾病，属于中医学“痛风”“历节风”“痹病”等范畴。随着现代生活方式的改变，该病多反复发作、缠绵难愈，可引起关节、肾脏等多器官功能损害及代谢异常。从“精气味”理论探讨痛风病机，认为本病以先后天之精不足为本，以五味偏嗜、损伤形气脏腑为发病关键，湿热浊毒瘀滞关节脏腑，出现一系列外在表现。在此基础上阐述以“五脏苦欲补泻”为核心的治疗理念，认为五味阴阳偏嗜引起病理损伤，必从药物阴阳为治，故从痛风相关脏腑及药物性味出发，提出治肝用辛补之、治脾以燥湿辛化、治肾以辛润苦坚的用药理念，以期为痛风的中医诊疗提供新思路。

    〔关键词〕 痛风;精化为气;气伤于味;五脏苦欲补泻;五味;病机;论治

    〔中图分类号〕R259" " " " "〔文献标志码〕A" " " " " 〔文章编号〕doi：10.3969/j.issn.1674-070X.2025.01.016

    Clinical essentials of applying \"tonifying or purging according to

    conditions of the five zang organs\" in gout treatment based on the

    theory of \"essence， qi， and flavor\"

    ZHAO Hang1， SONG Zongjian1， SU Mengyan1， LIU Kangnan1， ZHOU Zipeng2*

    1. Henan University of Chinese Medicine， Zhengzhou， Henan 450000， China; 2. Henan Province Hospital of

    TCM， Zhengzhou， Henan 450003， China

    〔Abstract〕 Gout， a common rheumatic and immunological disease in clinical practice， belongs to the categories of \"gout\"， \"joint wind\"， and \"arthralgia\" in Chinese medicine. With changes in modern lifestyles， this disease often recurs and is difficult to cure， potentially causing functional and metabolic abnormalities in joints ......