Research on the Progression of Pathogenesis in “Gout” with Turbidity, Stasis and Obstruction - Spleen Deficiency and Collateral Damage

Abstract

As a refractory metabolic disorder, gout poses challenges in long-term management for modern medicine due to adverse reactions and high recurrence rates, highlighting the unique advantages of holistic regulation in traditional Chinese medicine. Contemporary TCM perspectives on gout have deepened: Zhu Liangchun established “turbid-stasis obstruction” as the pathological core; Lu Zhizheng emphasised the spleen-stomach axis’s pivotal role in “Maintaining the Centre, Transporting to the Periphery” as the pivotal role of the spleen and stomach. Jiang Quan proposed “spleen-kidney deficiency” as the root cause of the disease, while Qin Guozheng focused on the microscopic pathological location of luo disease. Each scholar’s theory possesses distinctive characteristics, yet the logical relationships and evolutionary trajectory among them remain to be clarified. This paper, through systematic review of these discourses, identifies a progressive deepening in their conceptual framework: from the symptomatic focus on “turbidity and stasis” to the fundamental emphasis on “spleen and kidney deficiency,” and finally to the micro-pathological site of “collaterals.” Building upon this foundation, the study further explores a sequential therapeutic approach: “strengthening the spleen and tonifying the kidneys to consolidate the root, draining turbidity and resolving stasis to clear the source, and unblocking collaterals and dispersing nodules to reach the location.” This aims to construct a TCM diagnostic framework for gout integrating “manifestation-root-location,” providing a theoretical basis for clinical practice.