陈志雄从肝脾论治儿童原发性免疫性血小板减少症经验  

CHEN Zhi-Xiong’s Experience in Treating Children with Primary Immunologic Thrombocytopenic Purpura in Respect of Liver and Spleen

作　　者：卢诗颖 陈鹏[2] 陈志雄(指导)[2] LU Shi-Ying;CHEN Peng;CHEN Zhi-Xiong(The First Clinical Medical School of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China)

机构地区：[1]广州中医药大学第一临床医学院,广东广州510405 [2]广州中医药大学第一附属医院,广东广州510405

出　　处：《广州中医药大学学报》2022年第7期1658-1663,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省中医药局资助项目(编号:2100600156);陈志雄广东省名中医传承工作室建设项目。

摘　　要：总结陈志雄教授治疗儿童原发性免疫性血小板减少症(ITP)经验。陈志雄教授从肝脾之生理出发,认为ITP病机以肝不藏血、脾不统血为本,风邪、火热、瘀血为标,治疗以止血及预防出血为主要目标。治疗儿童ITP,需首辨急缓,急性期用药以祛风凉血止血为法,不可补益过早;慢性期用药以益气养阴为法,兼以祛邪化瘀;结合小儿“肝常有余,脾常不足”之特点,在辨证施治的基础上,以“平肝健脾,养血止血”为法,顾护小儿脾胃,以达“脾健肝畅”。临证中,灵活应用自拟经验方(由党参、白术、茯苓、炙甘草、巴戟天、肿节风、仙鹤草、茜草、玉米须组成),分期、随症加减,在治疗儿童ITP上疗效较佳。The experience of Professor CHEN Zhi-Xiong in treating primary immunologic thrombocytopenic purpura in children,also known as idiopathic thrombocytopenia(ITP)was summarized.Based on the physiology of liver and spleen,Professor CHEN Zhi-Xiong believes that the pathogenesis of ITP is characterized by the root pathogenesis of the liver failing in storing blood and the spleen failing in the control of the blood,and by the branch pathogenesis of wind pathogen,fire-heat,and blood stasis.The goal of ITP treatment is mainly aimed at stopping bleeding and preventing bleeding.During the treatment of ITP in children,the first step is to identify the chronic or emergent cases.In the acute stage,the medicine for dispelling wind and cooling blood to stop bleeding can be adopted,and the tonifying herbs should not be applied too early.In the chronic stage,the medicine for replenishing qi and nourishing yin can be used and herbs for eliminating pathogens to resolve stasis can be simultaneously utilized.With the considerations of the physiological characteristics of liver qi being always superabundant and spleen being prone to be deficiency in children,therapies of soothing liver and invigorating spleen,nourishing blood to stop bleeding can be used for the treatment of ITP children based on the syndrome differentiation and treatment,so as to prevent the spleen and stomach and ensure their normal function.For the treatment of ITP,flexible application of the self-prescribed formula,which is composed of Radix Codonopsis,Rhizoma Atractylodis Macrocephalae,Poria,Radix Glycyrrhizae Preparata,Radix Morindae Officinalis,Herba Sarcandrae,Herba Agrimoniae,Radix Rubiae and Stigmata Maydis,by staging and by appropriate modification according to the symptoms would achieve satisfactory therapeutic effect.

关 键 词：原发性免疫性血小板减少症 肝脾论治 平肝健脾 养血止血 陈志雄 

分 类 号：R255.7[医药卫生—中医内科学]