邓成珊运用异病同治法治疗出血性血液病  

Deng Chengshan's Application of Academic Idea of Different Diseases Treated with Same Treatment to the Hemorrhagic Blood Disease

作　　者：肖海燕[1] 刘为易 胡晓梅[1] 邓成珊[1] 

机构地区：[1]中国中医科学院西苑医院,北京100091

出　　处：《河南中医》2017年第9期1526-1528,共3页Henan Traditional Chinese Medicine

基　　金：国家中医药管理局全国名老中医传承工作室建设项目[编号:2011(42)];燕京名医邓成珊学术思想传承研究项目(编号:JJ2011-77);中国中医科学院"名医名家传承"项目(编号:CM20121026)

摘　　要：邓成珊认为血小板减少性紫癜急性多因外感热毒或热伏营血,以致火盛动血,灼伤脉络,迫血妄行而发病,临床以实证为主,部分实证病例随病情发展,火热之邪伤气耗阴可转为慢性。邓成珊认为风热毒邪是过敏性紫癜的发病之因,风热毒邪侵淫腠理,深入营血,即"热入血分",或素体阴虚血分伏热,复感风热毒邪,风热与血热相搏,脉络受损,血溢脉外。邓成珊认为血友病源于先天,肾为先天,主骨、生髓、藏精,肾阴虚为发病之本,阴不制阳,虚热内生,迫血妄行,或反复热毒外侵,热迫血行,故见各部位出血;一方面血溢脉外成瘀,瘀阻经络,不通则痛,故见关节疼痛不舒,日久见强直畸形;一方面瘀血内阻,气血壅滞,易内生郁热,故见关节红肿;三因反复出血,更损伤阴血,阴虚血少,内热丛生,形成恶性循环。邓成珊治疗血小板减少性紫癜、过敏性紫癜以及血友病等不同出血性疾病,根据异病同治理论,巧用犀角地黄汤变方化裁施治,获得稳定疗效。Deng Chengshan believes that thrombocytopenic purpura of acute type is mainly causes by exogenous heat toxicity or heat hiding in nutrient blood,leading to exuberant fire disturbing blood which burns the vessels and forces blood to flow out of the vessels. Clinically it is mostly excess syndrome. Some excess syndromes may develop into chronic type since heat and fire pathogen impairs qi and yin.,According to Deng,wind heat toxic pathogen is the cause of allergic purpura. Wind heat toxic pathogens attack the striae and interstitial space and reach the nutrient blood phase,which is ＂ heat entering blood phase＂. Or patients with yin deficiency have heating accumulating in blood phase and further contract wind heat toxic pathogen; wind heat struggles with blood heat,leading to impairment of vessels and blood flows out of the vessels. Deng holds that hemophilia is congenital. Kidney pertains to the congenital,dominates bone,produces marrow and stores essence. Kidney yin deficiency is the root cause. Yin fails to restrict yang,deficient heat generating internally and forcing blood to flow out of the vessels. Or repeated external attack of heat toxicity forces blood to flow out of the vessels,so bleeding appears in various areas. On the one hand,the blood out the vessels transforms into blood stasis blocking meridians and collaterals. Obstruction leads to pain,so joint pain and discomfort may appear with stiffness and malformation. On the other hand,blood stasis blocks internals leading to stagnation of qi and blood,which causes stagnant heat with manifestations of red and swelling joints. Recurrent bleeding may impairs the yin blood further more. Deficient yin results in deficient blood and generation of internal heat,making malignant circulation. In the treatment of thrombocytopenic purpura,allergic purpura and hemophilia,Deng skillfully uses Modified Rhinoceros Horn and Rehmannia Decoction based on the theory of different diseases treated with same treatment,which achieves steady efficacy.

关 键 词：异病同治 犀角地黄汤 血小板减少性紫癜 过敏性紫癜 血友病 邓成珊 

分 类 号：R255.7[医药卫生—中医内科学]