补肾益精法治疗免疫性血小板减少症的现代机制探讨  

Exploration of Modern Mechanism of Therapy of Nourishing Kidney and Replenishing Essence for the Treatment of Immune Thrombocytopenia

作　　者：李希[1] 陆嘉惠[2] 徐旻[1] 傅华[1] 沈伟[1] LI Xi;LU Jia-Hui;XU Min;FU Hua;SHEN Weil(Longhua Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China;Shanghai Municipal Hospital of Traditional Chinese Medicine,the Affiliated Hospital of Shanghai University of Traditional Chinese Medicine,Shanghai 200071,China)

机构地区：[1]上海中医药大学附属龙华医院,上海200032 [2]上海中医药大学附属市中医医院,上海200071

出　　处：《广州中医药大学学报》2023年第1期229-233,共5页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：上海中医药大学产业发展中心医养结合科创项目(编号:602084D)。

摘　　要：基于文献分析阐释“肾精”与免疫性血小板减少症(ITP)发病的关联,探究补肾益精法在ITP现代病理机制中的作用与物质基础。补肾益精法是上海市名中医姚乃中教授临证治疗ITP的重要方法,从肾出发遣方用药可有效改善ITP患者的临床症状与生活质量,提升血小板计数并减少出血表现。ITP发病的现代医学机制复杂,包括巨核细胞成熟障碍导致的血小板生成不足、细胞/体液免疫异常导致的血小板破坏增加以及出凝血平衡异常等;而补肾益精类药物具有促进巨核细胞成熟与分化、调控细胞/体液免疫、维持出凝血稳态等作用。补肾益精法治疗ITP的疗效机制可能与促进血小板生成、减少血小板破坏以及维持出凝血稳态等有关;中医学中“肾精”的概念可能涵盖了现代医学的骨髓造血干细胞、免疫细胞、凝血因子等。深入探究补肾益精法的现代机制内涵,将有助于提高ITP临床遣方用药的精确性与实效性。This paper discussed the connection between kidney essence and the pathogenesis of immune thrombocytopenia(ITP)based on the analysis of literature,and explored the role and material basis of the therapy of nourishing kidney and replenishing essence(Bushen Yijing method)in the modern pathological mechanism of ITP.The Bushen Yijing method is an important method for the clinical treatment of ITP advocated by Professor YAO Nai-Zhong,a renowned Chinese medicine practitioner in Shanghai.The use of prescriptions for the treatment of kidney can effectively improve the clinical symptoms and the quality of life of ITP patients,increase the platelet count and reduce bleeding manifestations.The modern pathological mechanism of ITP is complex,involving deficient platelet production due to impaired megakaryocyte maturation,increased platelet destruction due to abnormal cellular/humoral immunity,and abnormalities in bleeding and clotting homeostasis.In contrast,medicines for nourishing kidney and replenishing essence are known to promote the maturation and differentiation of megakaryocytes,regulate cellular/humoral immunity,and maintain bleeding and clotting homeostasis.Therefore,the therapeutic mechanism of Bushen Yijing method for the treatment of ITP may be related to the promotion of thrombocytopoiesis,reduction of platelet destruction and maintenance of bleeding and clotting homeostasis;the concept of kidney essence in the field of traditional Chinese medicine probably covers the bone marrow hematopoietic stem cells,immune cells and coagulation factors in the field of modern medicine.In-depth investigation into the modern therapeutic mechanism of Bushen Yijing method will be helpful for improving the accuracy and effectiveness of clinical prescriptions for ITP.

关 键 词：免疫性血小板减少症 补肾益精法 血小板生成 免疫细胞 出凝血稳态 姚乃中 

分 类 号：R255.7[医药卫生—中医内科学]