基于“玄府-络脉”理论探讨过敏性鼻炎病机与防治

Exploring allergic rhinitis pathogenesis, prevention, and treatment through the lens of xuanfu-collateral ^*

摘要

过敏性鼻炎的发病率高且难以治愈，是以鼻痒、喷嚏、流涕、鼻塞伴眼痒为主要临床表现的鼻腔炎性疾病。本文基于“玄府-络脉”理论，认为肺脾肾三脏虚损为本病的始动病理因素，络脉空虚、玄府失养，气机升降失衡，津液宣发与输布受阻，致湿邪、痰饮、瘀热为患，络脉受损进一步加重玄府闭塞。其病理阶段呈现虚-痰-瘀三阶递进。治法包括：健脾益气、补肺固玄；荣养玄络、固本培元；祛湿化痰、行气通络；清热活血、透络合玄。结合临床验案阐述基于“玄府-络脉”理论诊治过敏性鼻炎。

Abstract

Allergic rhinitis (AR) is a nasal inflammatory disease with a high incidence and considerable refractoriness, characterized by nasal itching, sneezing, rhinorrhea, nasal congestion accompanied by eye itching as the main clinical manifestations. Through the lens of xuanfu-collaterals, this paper holds that the deficiency of the lung, spleen and kidney is the initiating pathological factor of this disease. The deficiency of collaterals, malnutrition in xuanfu, imbalance of qi movement in ascending and descending, and obstruction of fluid diffusion and distribution lead to the invasion of dampness, phlegm-fluid and stasis-heat. The damaged collateral further aggravates the obstruction of xuanfu. Its pathological stages show a three-stage progression of deficiency-phlegm-stasis. The therapeutic method include: invigorating the spleen and replenishing qi, tonifying the lung and consolidating xuanfu; nourishing xuanfu and collaterals, strengthening the foundation and cultivating the original qi; eliminating dampness and resolving phlegm, moving qi and unblocking collaterals; clearing heat and activating blood, unblocking collaterals and harmonizing xuanfu. Combined with clinical proven cases, this paper expounds the diagnosis and treatment of AR based on the xuanfu-collaterals theory.

关键词

过敏性鼻炎 / 鼻玄府 / 络脉 / 病机 / 中医药治法

Key words

allergic rhinitis / nasal xuanfu / collateral vessels / pathogenesis / TCM treatment

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基金资助

山西省中医药管理局科研课题项目(2022ZYYZ056)

山西省卫生健康委科研课题项目(2025YGYL027)