基于“气虚络瘀、玄府失司”病机观论治变应性鼻炎  

Treatment of Allergic Rhinitis Based on the Pathogenesis of "Qi Deficiency and Collateral Stasis, Xuanfu Dysfunction"

作　　者：石磊[1] 舒福 曲中源[1] 马梽轩[1] 冷辉[1] SHI Lei;SHU Fu;QU Zhongyuan;MA Zhixuan;LENG Hui(Affiliated Hospitol of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,Liaoning,China;Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China)

机构地区：[1]辽宁中医药大学附属医院,辽宁沈阳110032 [2]辽宁中医药大学,辽宁沈阳110847

出　　处：《实用中医内科杂志》2022年第11期1-4,共4页Journal of Practical Traditional Chinese Internal Medicine

基　　金：国家中医药管理局第五批全国中医临床优秀人才研修项目(国中医药人教函[2022]1号);辽宁省第一批优秀中医临床人才项目(辽卫办发[2021]29号);沈阳市重点科技研发计划项目(17-230-9-48)。

摘　　要：变应性鼻炎(AR)是临床常见的过敏性疾病,与遗传、体质、环境等多种因素有关。随着络病理论、玄府理论研究的不断深入,特此提出“气虚络瘀、玄府失司”病机观,“气虚络瘀”重在强调肺、脾肾、三脏虚弱而致络脉元卫二气不足,外邪侵袭无力透邪外出,邪入鼻络以致痰蕴暗瘀反复、络脉瘀阻胶痼的总括;“玄府失司”只在表明AR演化过程中风、寒、热、湿等互结于络脉内外而致玄府开阖无度的病理状态;关键要义在于久病络伤、鼻络不荣、玄府失司、伏风内潜、痰瘀互结,且“气虚络瘀”“玄府失司”相互影响,共同左右AR发展进程。针对“气虚络瘀、玄府失司”病机观,确立“通补鼻络、疏通玄府”总体治则,并对临床用药规律与现代分子学机制加以详述,结合通络药及风药辨治特色以实现AR宏观微观结合调节,使得络脉玄府功能达到协同治疗目的,以期阐明络病理论、玄府理论的科学内涵,建立“气虚络瘀、玄府失司”病机观特色辨证治疗体系,为中医药治疗AR提供研究思路与理论基础。Allergic rhinitis(AR)is a common clinical allergic disease that is associated with a variety of factors such as genetics,constitution,environment and climate change.With the deepening of the study of collateral disease theory and Xuanfu theory,the concept of disease mechanism of"qi deficiency and collateral stasis,Xuanfu dysfunction"is hereby proposed.and"Qi deficiency and collateral stasis"focuses on emphasizing the weakness of the lung,spleen and kidney,resulting in insufficient promordial qi and defensive qi in collaterals,inability to resist exogenous pathogenic factors,and the pathogens enter the nasal collaterals with the result that resulting in repeated accumulation of phlegm and blood stasis."Xuanfu dysfunction"refers to the pathological state in wind,cold,heat,and dampness are intertwined inside and outside the collaterals during the evolution of AR,resulting in the pathological state of Xuanfu opening and closing.The key points lie in the long-term illness and collateral injury,the lack of honor of nasal collaterals,Xuanfu dysfunction,latent wind,and the combination of phlegm and blood stasis.The influence of"qi deficiency and collateral stasis"and"Xuanfu dysfunction"affects each other,ointly affecting the development process of AR.In view of the pathogenesis concept of"qi deficiency and collateral stasis,Xuanfu dysfunction",the overall treatment principle of"tonifying nasal collaterals and dredging Xuanfu"was established,,and the clinical drug rules and modern molecular mechanisms were described in detail.and the characteristics of the identification and treatment of activating collateral drugs and expelling wind drugs were combined to achieve the macro and micro combination adjustment of AR,so that the function of collaterals and Xuanfu could achieve the purpose of synergistic treatment in order to clarify the scientific connotation of the theory of collateral disease and Xuanfu,and establish a dialectical treatment system with the characteristic pathogenesis of"Qi Deficiency and Collateral Stasis,Xu

关 键 词：气虚络瘀 玄府失司 变应性鼻炎 中医药 分子学机制 

分 类 号：R276.1[医药卫生—中医五官科学]