基于分型证治及“态靶因果”探讨原发性血小板增多症的中医治疗  

Discussion on the Treatment of Essential Thrombocytosis Based on Syndrome Classification and Theory of“Status,Target,Etiology and Results”

作　　者：蒋楠[1] 魏学礼[1] 欧田田 代兴斌 JIANG Nan;WEI Xue-Li;OU Tian-Tian;DAI Xing-Bin(Dept.of Hematology,Wuxi Traditional Chinese Medicine Hospital,Wuxi 214071 Jiangsu,China;Dept.of Hematology,Jiangsu Provincial Hospital of Traditional Chinese Medicine,the Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029 Jiangsu,China)

机构地区：[1]无锡市中医医院血液科,江苏无锡214071 [2]南京中医药大学附属医院血液科,江苏南京210029

出　　处：《广州中医药大学学报》2021年第10期2278-2281,共4页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：无锡市2019年度“太湖人才计划”国际国内顶尖医学团队(锡组通【2019】68号)。

摘　　要：原发性血小板增多症可归属于中医学“血积”“髓实”“积聚”的范畴。作为一种慢性骨髓增殖性肿瘤,单纯的分证论治不足以构建原发性血小板增多症的中医诊疗体系。本文基于“态靶因果”的诊治思路,即根据原发性血小板增多症患者的“整体证候特征”(“态”)及其具体症状或异常指标(“靶”),通过当前的“态”推测其发生的原因(“因”),并预测将来会出现的病理结果(“果”),采取相应的治疗措施,以提前预防,达到“治未病”效果。通过探讨原发性血小板增多症的分期与分型的辨证论治思路,认为原发性血小板增多症可以热毒、痰湿、瘀血、寒凝、肾虚5型论治,可分别选用靶方犀角地黄汤、导痰汤、通脉活血汤、阳和汤和大补阴丸来调整患者内环境,同时可选用主要由大血藤、猕猴桃根、冬凌草、八角莲、瓦楞子、海藻、昆布、水蛭、土鳖虫、全蝎、肉桂、墨旱莲等组成的靶药组合。Essential thrombocytosis can be classified into the category of“blood accumulation”,“myeloid aggregation”,“aggregation-accumulation”in the field of traditional Chinese medicine.As a kind of chronic myeloproliferative tumor,simple syndrome differentiation is not enough to construct the Chinese medicine diagnosis and treatment system for essential thrombocytosis.During the long-term clinical practice and based on the theory of“status,target,etiology and results”,we explored the thoughts for the treatment of essential thrombocytosis by using staging and syndrome classification.The theory of“status,target,etiology and results”means that after the analysis of the holistic syndrome features(“status”)and the specific symptoms or abnormal indicators(“target”),the cause of the disease(“etiology”)can be deduced and the pathogenic results(“results”)can be predicted,and then the corresponding preventive and therapeutic methods can be used,so as to achieve the results of preventive treatment of the disease.It is believed that essential thrombocytosis can be differentiated as the syndrome types of heat toxicity,phlegm and dampness,blood stasis,cold coagulation and kidney deficiency,and can be separately treated by the target prescriptions of Xijiao Dihuang Decoction,Daotan Decoction,Tongmai Huoxue Decoction,Yanghe Decoction,and Da Buyin Pills for adjusting the balance of the patients’internal environment.At the same time,the combination of target herbs such as Caulis Sargentodoxae,Radix Actinidae Chinensis,Herba Rabdosiae Rubescentis,Rhizoma Dysosmae Pleianthae,Concha Arcae,Sargassum,Thallus Laminariae et Eckloniae,Hirudo,Eupolyphaga seu Steleophaga,Scorpio,Cortex Cinnamomi,and Herba Ecliptae can be used.

关 键 词：原发性血小板增多症 热毒 痰湿 寒凝 瘀血 肾虚 靶方 靶药组合 

分 类 号：R558.3[医药卫生—血液循环系统疾病]