基于叶天士奇经理论治疗慢性再生障碍性贫血探析  

Exploration on the Treatment of Chronic Aplastic Anemia Based on YE Tianshi's Extra Meridian Theory

作　　者：吕纯懿 王琰[2] 徐瑞荣[2] LYU Chunyi;WANG Yan;XU Ruirong(Shandong University of Traditional Chinese Medicine,Jinan 250014,Shandong,China;Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Key Laboratory of Integrated Traditional Chinese and Western Medicine for Hematology,Health Commission of Shandong Province,Institute of Hematology,Shandong University of Traditional Chinese Medicine,Jinan 250014,Shandong,China)

机构地区：[1]山东中医药大学,山东济南250014 [2]山东中医药大学附属医院,山东省卫健委中西医结合血液学重点实验室,山东中医药大学血液病研究所,山东济南250014

出　　处：《辽宁中医药大学学报》2024年第8期79-83,共5页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(82174181);山东省自然科学基金重点项目(ZR2020KH023);“泰山学者青年专家”项目(tsqn202211351)。

摘　　要：慢性再生障碍性贫血以骨髓造血功能衰竭为特征,其发病与脾肾两脏关系密切,属慢性虚损性疾病。从奇经施治是清代医家叶天士重要的治虚理念,该文以此切入,挖掘叶氏奇经理论内涵,并基于此探析慢性再生障碍性贫血的病机与治疗。奇经赖肝肾精血荣养、脾胃精气充盈,虚损性疾病具有由脏腑延及奇经的趋向,且奇经在生理、病理方面具有络的属性,奇经气血空乏日久,可出现虚实夹杂、病位深远的“久病入络”特征。基于叶氏奇经理论进一步将慢性再生障碍性贫血病机阐发为“脏腑亏损-奇经乏源”与“奇络虚滞”,启示慢性再生障碍性贫血临证治疗时除补益脏腑之外,亦需着眼于通补奇经,兼顾行络中滞涩,且针对慢性再生障碍性贫血的病程特点,治宜缓图其功,以期达虚损渐复的疾病向愈目的。Chronic aplastic anemia is a chronic debilitating disease characterized by bone marrow hematopoietic failure,and its pathogenesis is closely related to the spleen and kidney.Tonifying deficiency from the perspective of extra meridian is an important idea developed by YE Tianshi,a physician from the Qing Dynasty.This paper aims to excavate the theoretical connotation of YE's theory of extra meridian and elucidate the pathogenesis and treatment of chronic aplastic anemia based on this theory.The maintenance of normal physiological functions of the extra meridian depends on the nourishment of liver and kidney essence and blood,as well as the spleen and stomach essence and Qi.Debilitating diseases have a tendency from the viscera and bowels to the extra meridian,which have collateral properties in physiology and pathology.When Qi and blood in the extra meridian are depleted for a long time,there may develop the characteristics of“chronic diseases affecting collaterals”with a deficiency-excess complex and deep infiltration.Based on YE's theory of extra meridian,the pathogenesis of chronic aplastic anemia is further elucidated as“deficiency of Qi and blood in viscera and bowels-lack of nourishment of extra meridian”and“deficiency and stagnation of extra meridian”.This reveals that in the clinical treatment of chronic aplastic anemia,besides tonifying the viscera and bowels,it is also necessary to pay attention to dredge and tonify the extra meridian,taking into account stagnation in collaterals.The course characteristics of chronic aplastic anemia should be considered,and the treatment should not be rushed in order to achieve the purpose of gradual remission and recovery from the disease.

关 键 词：再生障碍性贫血 叶天士 奇经 通补 

分 类 号：R22[医药卫生—中医基础理论]