基于卫气营血-经络系统从三焦论治原发免疫性血小板减少症  

A study on treating primary immune thrombocytopenia from the perspective of Sanjiao based on Wei Qi Ying Xue-meridian system

作　　者：单凡 张福利[1] SHAN Fan

机构地区：[1]黑龙江中医药大学,黑龙江哈尔滨150040

出　　处：《中医临床研究》2024年第16期54-58,共5页Clinical Journal Of Chinese Medicine

基　　金：第七批全国老中医药专家学术经验继承工作项目(国中医药人教函[2022]76号)。

摘　　要：张福利教授将叶桂(字天士)核心辨证思想中的卫气营血辨证和络病辨证相融合,得出疾病以卫表阳络—气经—营血阴络的病理机制传变。在此卫气营血—经络系统复合观的纲领下,张福利教授首先创见性地提出以湿热为因、三焦为枢,将内伤杂病中病邪由气经入营血阴络的病进路径具象化,即气经湿热,流连三焦,则三焦气化失司,痰浊内生,滞留于阴络缠绊处,孙络端津血互化受累,痰浊浸淫,血液代谢不出,累及血质;营卫交会受阻,营卫不畅,累及血行,最终血渐瘀积,瘀血生燥化热,内外相合,致使营血阴络瘀热。因此,首先,将杂病病机转趋概括为气经湿热—三焦湿热痰浊—营血阴络瘀热。其次,从微观角度推演出原发免疫性血小板减少症因痰浊积蓄于阴络缠绊处,阻碍营气、津液化生血液,血虚之证渐成等虚损证候病机;因营血阴络瘀热,瘀热之邪迫使血溢脉外,出血之症渐现等出血证候病机。最后,结合复合观层次性和系统性特点,针对气经、营血阴络、三焦不同病层的生理病理特性并且综合卫气营血—经络系统中疾病内侵外透的贯通趋势,构成单层对治、多层同治、逐层透转、顺势祛邪的大方复合法,施用于临床治疗。Professor ZHANG Fuli integrated YE Gui’s core syndrome differentiation thought of Wei Qi Ying Xue(卫气营血)and collateral disease differentiation.It is concluded that the disease progression is in the sequence of Yang collaterals(阳络)-Qi channel(气经)-Yingxue Yin collaterals(营血阴络).Under the guideline of the compound concept of the Wei Qi Ying Xue-meridian system.Professor ZHANG Fuli first creatively proposed the idea of taking dampness-heat as the cause and Sanjiao(三焦)as the center,and concreting the progression route of pathogenic factors from Qi channel to Yingxue Yin collaterals in internal injuries and miscellaneous diseases.That is,the dampness and heat of Qi channel remain in Sanjiao,which leads to dysfunction of Sanjiao,and then causes the phlegm to be endogenous and remain in Yin collateral entanglements.The inter-conversion of body fluid and blood of minute collateral is affected,resulting in phlegm turbidity invasion and blood metabolism disorder,which impacts blood quality.The intersection of Yingqi(营气)and Weiqi(卫气)is blocked,resulting in blocked Yingqi and Weiqi,and the blood circulation is affected.Finally,the blood is gradually accumulated,and blood stasis leads to dryness and heat,when internal and external pathogenic factors are compatible with each other,stasis and heat are generated in Yingxue Yin collaterals.Therefore,firstly,the pathogenesis transformation trend of miscellaneous diseases is summarized as Qi channel dampness-heat,Sanjiao damp-heat phlegm turbidity,Yingxue Yin collateral stasis and heat in order.Secondly,the pathogenesis of primary immune thrombocytopenia was deduced from the microscopic point of view,namely the accumulation of phlegm turbidity in Yin collateral entanglements obstructs the transformation of Yingqi and body fluid into blood,resulting in deficiency-damage syndromes such as blood deficiency syndrome gradually.Because of Yingxue Yin collateral stasis and heat,blood is forced to overflow outside the pulse,resulting in bleeding syndromes

关 键 词：气经 营血阴络 三焦 痰浊 复合法 

分 类 号：R256[医药卫生—中医内科学]