风寒湿邪杂至合而为痹,与肝脾肾不足,或血虚血瘀痰滞密切相关。既可气机不利关节痹痛,也可气郁兼风湿痹痛,或风湿痹痛而气滞邪阻。治宜舒肝解郁,调气通络,祛风除湿,可选用逍遥散加减。或治宜调畅少阳枢机利气机调和营卫祛风湿,可选用小柴胡汤合桂枝汤加减,或小柴胡汤合四妙散加减。脾肾阳虚不足,气血亏虚为痹证常见病机,阳虚痹痛多见,较易辨证,而痹证伴阴虚,或阴虚痹证并非少见,因辨识较难,故易辨为风痹或风湿痹痛。阴虚痹痛多见于指趾关节,或阴虚臂痛,关节痹痛日轻夜重,全身筋脉挛缩,伴有头晕、头痛,咽干耳鸣,少寐,大便干燥, ......