摘要
国医大师丁樱认为,儿童原发性免疫性血小板减少症(immune thrombocytopenia,ITP)病机为本虚标实,中焦脾胃失和为本,周身脉络不宁为标,提出调中安络法为主要治则,调中健运、祛邪安络为治疗大法。根据不同ITP患儿所处病程及临证表现不同,祛邪之法又可细分为疏风散热以安络、凉血解毒以安洛、滋阴清热以安络、活血化瘀以安络。临证以调中健运治其本,以归脾汤为基础,重用生黄芪、当归益气补血,佐太子参、白术、茯苓助脾运气、调中健运;同时兼以祛邪安络治其标,当辨其风热、血热、虚热、瘀血合方加减化裁,选方用药上借“取象比类”之意,活用藤类药物祛络之伏邪,防其瘥后易复。
Ding Ying,Master of Traditional Chinese Medicine,believes that the pathogenesis of primary immune thrombocytopenia(ITP)in children is based on deficiency and excess,the disharmony of the Spleen and Stomach in Zhongjiao is the root cause,and the restlessness of the whole body′s veins is the symptoms.He proposed the method of regulating Zhongjiao and easing meridian as the main treatment principle,and the method of regulating the Zhongjiao to promote health and removing pathogenic factors to ease collateral as the main treatment method.According to the different course and clinical manifestations of ITP patients,the methods of dispelling pathogenic factors can be further divided into dispersing Wind and dissipating Heat to soothe the collateral,cooling blood and detoxifying to soothe the collateral,nourishing Yin and clearing Heat to soothe the collateral,and promoting blood circulation and resolving stasis to soothe the collateral.In clinical practice,the principle of regulating the Spleen′s vital energy is to treat the Spleen′s vital energy.Based on Guipi Decoction,Huangqi(radix astragali)and Danggui(Angelica)are used to replenish Qi and blood,while Taizishen(Radix Pseudostellariae),Baizhu(Atractylodes macrocephala)and Fuling(Poria cocos)are used to assist the regulating of the Spleen′s vital energy and promoting the Spleen′s vital energy.At the same time,it is also necessary to treat the underlying symptoms by dispelling pathogenic factors and calming the collateral.When distinguishing between Wind Heat,blood Heat,deficiency Heat and blood stasis,the combination formula should be modified accordingly.When selecting the prescription and using it,the meaning of"Qu Xiang Bi Lei"should be borrowed,and vine like drugs should be used to dispel the underlying pathogenic factors and prevent them from recurrence after recovery.
作者
李宇迪
徐炎
李东林
丁樱
LI Yudi;XU Yan;LI Donglin;DING Ying(Henan University of Chinese Medicine,Zhengzhou Henan China 450046;The First Affiliated Hospital to Henan University of Chinese Medicine,Zhengzhou Henan China 450000)
出处
《中医学报》
CAS
2023年第11期2370-2374,共5页
Acta Chinese Medicine
基金
国家自然科学基金面上项目(81873343)
国家自然科学基金青年基金项目(82205190)
国医大师工作室建设项目{国中医药人教发[2022]245号}
中国博士后科学基金面上项目(2023M731027)
河南省博士后项目(HN2022096)。
关键词
免疫性血小板减少性紫癜
调中健运
祛邪安络
丁樱
国医大师
immune thrombocytopenic purpura
adjusting Zhongjiao to promote health
dispelling Evil factors to ease collateral
Ding Ying
Traditional Chinese Medicine Master
