下肢动脉硬化性闭塞症的五期衍化及辨治  

Five-stage Development and Treatment of Lower Extremity Arteriosclerotic Occlusive Disease

作　　者：雷天浩 闫英 LEI Tianhao;YAN Ying(The Third Affiliated Hospital to Beijing University of Chinese Medicine,Beijing China 100029)

机构地区：[1]北京中医药大学第三附属医院,北京100029

出　　处：《中医学报》2024年第7期1422-1427,共6页Acta Chinese Medicine

基　　金：北京市中医药科技发展资金项目(JJ-2023-95)。

摘　　要：气府、卫总管、气管构成气流动的网络;血府、荣总管、血管构成血流行的体系。气管之跳动,血管之静谧为脉之阴阳两种状态。下肢动脉硬化性闭塞症的发病分为五期,首先,风寒外侵为初病之源,此期病机特点为风寒扰卫,寒凝络脉;其次,寒攻卫损为进展之因,此期病机特点为邪亢卫挫,寒伤卫阳;再次,营脉遏郁为内伤之核,此期病机特点为卫败营伤,瘀血停脉;从次,热灼阴亏为病变之枢,此期病机特点为营瘀生热,灼脉伤津;最后,毒滞脉溃为终末之根,此期病机特点为津灼化毒,脉溃阴竭。此五期衍化皆与气血脉及营卫相关,尤其在内伤之核阶段,营脉瘀遏是病机转折点,故而治疗上倡导以复卫总管、荣总管之功而调营卫,益气充营以畅经脉,进而截断病程,转危为安。通过调气、复卫、固营、合脉,最终达到清虚和畅,透达营卫的目的。The network of Qi flow is composed of Qi Fu,the main pipe of Wei Qi and trachea,while blood Fu,Rong blood pipe and blood vessel constitute the system of blood flow.The aacting of the trachea and the quietness of the blood vessels are two states of Yin and Yang of the pulse.The pathogenesis of lower extremity arteriosclerotic obliterans is divided into five stages.First,Wind-Cold invasion from outside is the primary source of the disease,and the pathogenesis of this stage is Wind-Cold disturbing the Wei Qi and chilling stagnation in collaterals.Secondly,Cold attack induced Wei Qi injury is the cause of progress,and the pathogenesis of this stage is characterized by evil factor overactivity induced Wei Qi injury,or Cold injuring Wei Yang.Thirdly,Ying blood stagnation in meridian is the core of internal injury.The pathogenesis of this stage is Wei Qi failure and Ying blood injury and the result of blood stasis stopping in meridians.Fourthly,Heat burning and Yin deficiency is the focal point of the lesion,and the pathogenesis of this stage is characterized by Ying blood stasis generated Heat,which burns in meridians and injuries body Fluid;Finally,Toxin stagnation induced meridian collapse is the ultimate result,and the pathogenesis of this stage is characterized by the burnt Fluid induced toxin and the exhaustion of meridian and Yin.These five stages of development are related to Qi and blood in general sense as well as the main pipe of Ying blood and Wei Qi,especially in the nuclear stage of internal injury,Ying blood stasis in meridians is the turning point of the pathogenesis.Therefore,in treatment,it is advocated to regulate Ying and Wei function of restoring and enriching the health,supplementing Qi and filling Ying to smooth the meridians,and then cut off the course of the disease and turn the crisis into peace.Through regulating Qi,restoring Wei Qi,strengthening Ying blood and harmonizing meridians,the purpose of deficiency clearing,Qi smoothing as well as Ying blood and Wei Qi communication and balance is fi

关 键 词：下肢动脉硬化性闭塞症 “气血合脉” 风寒触卫失宣期 卫损邪亢寒凝期 卫危营损脉瘀期 营瘀化热津伤期 热灼津毒脉溃期 

分 类 号：R261[医药卫生—中医外科学]