摘要
免疫性血小板减少症(Immune thrombocytopenia,ITP)为临床常见的出血类疾病,属中医“紫癜病”范畴。其发病机制尚未完全阐明,临床以慢性ITP(Chronic primary immune thrombocytopenia,cITP)多见,病程长,易复发,患者可伴有焦虑、乏力等不适症状,影响患者生活质量。中医学认为cITP多属本虚标实,本虚为阴虚、气虚、阳虚,病位在肝、脾、肾,标实为热和瘀。《脾胃论》中的“阴火”是指由于内伤脾胃、元气亏损所致的气火失调,其内涵与cITP的病机特点和治疗关系密切。胡晓梅教授基于“阴火”理论,结合自身临床经验,认为脾气虚为cITP的主要病机,治疗以补脾气、泻阴火为治疗原则,以甘温益气的四君子汤为主加减用药。通过中医传承计算平台(V3.0)软件客观分析胡晓梅教授临床用药规律,佐证了其从“阴火”论治cITP的思路。该思路指导下用药可有效提高患者血小板计数,提升总有效率,临床疗效显著。
Immune thrombocytopenia(ITP)is a common clinical bleeding disorder,which belongs to the category of“purpura disease”in traditional Chinese medicine(TCM).The pathogenesis of this disease has not been completely clarified.The chronic immune thrombocytopenia(cITP)is common in clinic,with prolonged course andeasy recurrence.Patients with cITP are accompanied by anxiety,fatigue,and other discomfort symptoms,which affect the quality of life.According to TCM,the pathogenesis of this disease is asthenia in origin(the deficiency of yin,qi and yang in liver,spleen,and kidney)and sthenia in superficiality(heat and blood stasis).The term“Yin Fire”in the Treatise on the Spleen and Stomach refers to the imbalance of qi and fire due to internal damage to the spleen and stomach and insufficiency of primordial qi,and its connotation is closely related to the pathological characteristics and treatment of cITP.Based on the theory of“Yin Fire”and her own clinical experience,ProfessorHu Xiaomei believes that deficiency of spleen qi is the main pathogenesis of cITP,and themodified Sijunzi Decoction,which is sweet,warm,and tonifying qi,is mainly used to treat cITP according to the principle of tonifying spleen qi and purging yin fire.In this paper,the TCM inheritance computing platform(V3.0)was used to analyze Professor Hu's medication rules,thus proving the idea of treating cITP from the theory of“Yin Fire”.The clinical application under the guidance of this therapeutic idea effectively increases the platelets of patients and improves the overall efficiency,with significant clinical efficacy.
作者
孙妍
曹新甜
赵霈
邹吉轩
宋英
王明镜
胡晓梅
SUN Yan;CAO Xin-tian;ZHAO Pei;ZOU Ji-xuan;SONG Ying;WANG Ming-jing;HU Xiao-mei(Xiyuan Hospital,Clinical Medical College of Beijing University of Chinese Medicine,Beijing 100091;Department of Hematology,Xiyuan Hospital of China Academy of Chinese Medical Sciences,Beijing 100091)
出处
《世界中西医结合杂志》
2022年第6期1265-1269,共5页
World Journal of Integrated Traditional and Western Medicine
基金
国家重点基础研究发展计划(973计划)项目(2015CB554403)。
