从脾肾论治原发免疫性血小板减少症研究进展  

Research Progress on Treatment of Primary Immune Thrombocytopenia Based on Spleen and Kidney Theory

作　　者：张瑞峰 鲍计章[1] 周永明[1] ZHANG Ruifeng;BAO Jizhang;ZHOU Yongming(Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai China 200437)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院,上海200437

出　　处：《中医学报》2020年第2期285-290,共6页Acta Chinese Medicine

基　　金：国家自然科学基金项目(81774258);上海中医药大学名老中医药专家学术经验研究工作室项目(SZYMZYGZS4018);上海市名老中医学术经验研究工作室项目(SHGZS-2017019)。

摘　　要：以"脾统血""肾生髓化血"为理论依据,结合辨证论治与中药灵活配伍,以健脾补肾法治疗原发免疫性血小板减少症(primary immune thrombocytopenia,ITP),在提升血小板和改善疾病相关症状上与西医使用激素类药物治疗相比具有一定的优势。文献研究表明,ITP本身所产生的各种症状,正是中医药辨证治疗的优势,以健脾补肾法为指导,围绕该病的病因病机制定治法方药,不仅能改善疾病相关症状,还能一定程度上调节人体的免疫失衡。但目前中医药治疗ITP的研究仍存在一些问题:研究多围绕治疗前后血小板计数和免疫指标的变化进行,偏重对治疗结果的比较,尚未阐明中医证型与免疫机制的具体作用原理及疗效机制。今后可通过探究不同中医证型的相关免疫差异,探索出与ITP具有特异性联系的研究指标,提高中医药对ITP治疗的认知,同时,进一步探讨本疗法对相关机制通路的影响及其作用机制,确定中药复方具体的作用靶点,为新药的研发提供思路。Based on the theoretical basis of "Spleen producing Blood" and "Kidney deriving marrow and then producing Blood",combined with the dialectical therapy and flexible compatibility of traditional Chinese medicine,the method of strengthening the Spleen and tonifying the Kidney to treat primary immune thrombocyto penia (ITP) Platelets and improvement of disease-related symptoms have certain advantages compared with western medicine using hormone drugs. Literature research suggests that the various symptoms produced by ITP itself are the advantages of TCM syndrome differentiation. Guided by the method of strengthening the spleen and kidney,and formulating treatment methods around the etiology and pathogenesis of the disease,not only can improve disease-related symptoms,but also can regulate the body’s immune imbalance to a certain extent. However,there are still some problems in the research of Chinese medicine treatment of ITP: the research mostly focuses on the changes of platelet count and immune index before and after treatment,and focuses on the comparison of treatment results. In the future,we can explore the relevant immune differences of different TCM syndrome types,explore research indicators that are specifically related to ITP,and improve the understanding of ITP treatment in Chinese medicine. At the same time,further explore the impact of this therapy on related mechanism pathways and their effects Mechanism to determine the specific target of the traditional Chinese medicine compound,and provide ideas for the development of new drugs.

关 键 词：原发免疫性血小板减少症 从脾论治 从肾论治 从脾胃论治 滋肾阳 温肾阳 

分 类 号：R259[医药卫生—中西医结合]