从“正气化邪”探析自身免疫病的病机及辨治  

Discussion on Disease Mechanism,Pattern Differentiation,and Treatment of Autoimmune Diseases Based on the Theory of"Transformation of Healthy Qi into Pathogenic Qi"

作　　者：尧忠柳 王莘智[1] 叶新萍[1] 蔡雄[1] 刘良 YAO Zhongliu;WANG Shenzhi;YE Xinping;CAI Xiong;LIU Liang(The First Hospital of Hunan University of Chinese Medicine,Changsha,410007;National Key Laboratory of Traditional Chinese Medicine Syndromes, Guangzhou University of Chinese Medicine)

机构地区：[1]湖南中医药大学第一附属医院,湖南长沙410007 [2]广州中医药大学中医证候全国重点实验室

出　　处：《中医杂志》2024年第10期1013-1018,共6页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(82274506);湖南省研究生科研创新项目(CX20220816);湖南中医药大学“刘良院士工作站”指导项目(23YS001)。

摘　　要：基于免疫系统在生理与病理状态下的“正”“邪”双重性,并结合将“免疫功能”和“正气”类比的认识,提出“正气化邪”理论用以指导自身免疫病的辨治。“正气化邪”即机体原本用以防御和清除各有害因素的能力或正常功能活动的“正气”,转化为损伤破坏人体的因素或异常机体状态即“邪气”。在自身免疫病的发病过程中,提出先天禀赋、外邪影响下的组织损伤、脏腑经络功能异常、气血津液输布气化失常的化邪条件和成因。自身免疫病具有前驱期为邪气化生而伏、发病期为内外感召而发、全周期邪气扩展的动态性病机,还具有正气化邪的特异性、隐匿性和矛盾性等特点。治疗方面倡导攻补兼施之法贯穿始终,专病专方专药的辨病思想,辨析疾病缓解与发作的动态以调整治疗,观察正气化邪之态势变化进行早期干预的治未病思想。Based on the duality of"healthy"and"pathogenic"of the immune system in physiological and pathological states,and combined with the analogy between"immune function"and"healthy qi",the theory of"transformation of healthy qi into pathogenic qi"was proposed to guide the pattern identification and treatment of autoimmune diseases.The theory of"transformation of healthy qi into pathogenic qi"means that"healthy qi",which is originally used by the body's original ability to defend and remove harmful factors or normal functional activities,transformed into"pathogenic qi",which is factors that damage and destroy the human body or abnormal body state.In the pathogenesis of autoimmune diseases,the pathogenic factors and causes of congenital endowment,tissue damage under the influence of external pathogens,abnormal function of zang-fu(脏腑)organs and meridians,abnormal transmission and transformation of qi,blood,body fluids was proposed.Autoimmune diseases have the dynamic mechanism of latent pathogen at early stage,internal and external contraction at the onset stage,and the expansion of the pathogenic qi at the complete period,and also have the characteristics of the specificity,invisibility and contradiction of healthy qi and pathogenic qi.In terms of treatment,it advocates the ideas of treatment with both attack and supplementation throughout the disease,identifying diseases with special prescriptions and formulas for specific diseases,dynamically adjusting treatment by identifying the remission and onsets of the disease,observing the changes in the dynamics of healthy qi transforming into pathogenic qi,and treating disease before it arises with early intervention.

关 键 词：自身免疫病 正气 邪气 免疫 

分 类 号：R259[医药卫生—中西医结合]