凉血解毒方治疗免疫性血小板减少的理论探析

Theoretical Analysis of Liangxue Jiedu Decoction in Treating Immune Thrombocytopenia

摘要

免疫性血小板减少症（immune thrombocytopenia，ITP）是临床高发获得性出血性疾病，现代医学治疗易复发、长期疗效不确定，中医药联合治疗优势显著。结合中医理论及历代医家认知，ITP核心病机为血热为始动因素、血瘀为中心环节、正虚为根本基础，三者交织伴气机逆乱形成恶性循环。据此构建以凉血解毒方为核心的辨证治法体系：急性期清热凉血解毒、透邪外出；全程兼顾化瘀与收敛止血；阴虚血瘀者滋阴活血并用；慢性期益气健脾摄血。契合ITP本虚标实、热瘀互结病机，彰显中医辨证论治、标本兼顾思想，为临床治疗提供理论支撑。

Abstract

Immune thrombocytopenia (ITP) is a clinically prevalent acquired hemorrhagic disease. Modern medical treatment is prone to recurrence with uncertain long-term efficacy, while combined treatment with traditional Chinese medicine (TCM) shows significant advantages. Based on TCM theory and the understanding of physicians in successive dynasties, the core pathogenesis of ITP is blood heat as the initiating factor, blood stasis as the central link, and healthy qi deficiency as the fundamental basis. These three factors interweave with qi movement disturbance to form a vicious cycle. Accordingly, a syndrome differentiation-based treatment system centered on Liangxue Jiedu Decoction (Cooling Blood and Detoxifying Decoction) is constructed: in the acute phase, clearing heat, cooling blood and detoxifying are adopted to expel pathogenic factors; throughout the entire treatment course, promoting blood circulation to remove stasis and astringent hemostasis are taken into account; for yin deficiency with blood stasis, nourishing yin and promoting blood circulation are used together; in the chronic phase, tonifying qi, invigorating the spleen and controlling blood are implemented. This system conforms to the pathogenesis of ITP characterized by deficient root and excessive branch as well as intermingled heat and stasis, demonstrates the TCM concepts of syndrome differentiation-based treatment and simultaneous treatment of root and branch and provides theoretical support for clinical treatment.

关键词

免疫性血小板减少 / 凉血解毒方 / 病因病机 / 理论探讨

Key words

immune thrombocytopenia / Liangxue Jiedu decoction / etiology and pathogenesis / theoretical discussion

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