基于“治血四法”辨治干燥综合征相关高球蛋白血症性紫癜  

Treating Sj gren Syndrome-associated Hyperglobulinemic Purpura Based on"Four methods in Treating Blood Syndrome"

作　　者：耿昭阳 杨琨 刘宏潇[2] GENG Zhaoyang;YANG Kun;LIU Hongxiao(Beijing University of Chinese Medicine,Beijing China 100029;Guang′anmen Hospital,China Academy of Chinese Medical Sciences,Beijing China 100053)

机构地区：[1]北京中医药大学,北京100029 [2]中国中医科学院广安门医院,北京100053

出　　处：《中医学报》2024年第12期2533-2537,共5页Acta Chinese Medicine

基　　金：中国中医科学院科技创新工程重大攻关项目(CI2021A01506);中国中医科学院科技创新工程重点协同攻关项目(CI2023C072YLL);中央高水平中医医院临床研究和成果转化能力提升项目(HLCMHPP2023049)。

摘　　要：干燥综合征相关高球蛋白血症性紫癜起于燥,“燥胜则干”,且此病之燥,乃燥邪日盛,蕴久成毒,煎灼阴津,伤及脏腑而成。本病的基本特点为燥伤津液、燥甚成毒。临证运用《血证论》提出的治血四法,即“止血、消瘀、宁血、补虚”。治疗当分清邪正盛衰,补其不足,泻其有余:有邪者当急祛其邪,燥毒内盛、迫血妄行者,当解毒润燥、止血塞流;气逆血溢者,当顺气宁血;血瘀阻络者,当消瘀通络,血自归经;正虚者当扶其正;血虚者宜补之;血涩者宜润之;病在肝者当疏肝养肝;病在肺者当润肺养阴;病在脾者当健脾益气;病在肾者当滋肾填精。Sj gren syndrome-associated hyperglobulinemic purpura starts from Dryness since"great dryness means drought".The Dryness in this disease is long-term Dryness induced drought toxin,which injures the body Fluid as well as the Zang and Fu.Therefore,the basic characteristics of this disease are Dryness injuring the body Fluids and Dryness Toxin is brought about eventually.In clinical practice,the four methods in treating blood syndrome,namely,"stopping bleeding,eliminating blood stasis,nourishing blood and tonifying deficiency",can be applied.In treatment,different cases,i.e.the prosperous or declining of the evil factors and Zheng Qi of human body should be clearly distinguished,in order to make up for its deficiency and reduce the excess:for Dryness Toxin prevalence induced bleeding,detoxification and moistening Dryness,hemostatic plug flow should be carried out;for reversed Qi flow induced blood spilling out,regulating Qi is the key to calm the blood flow;for blood stasis obstructing the collaterals,eliminating the blood stasis and dredging the collaterals should be focused to help the blood return to the meridian;for Zheng Qi deficiency tonifying the Zheng Qi is the primary step;for blood deficiency nourishment is appropriate;for blood astringency moistening it is appropriate;when the disease is in the Liver,soothing and nourishing the Liver;when disease is in the Lung,moisturizing the Lung to nourish Lung Yin;when the disease is in the Spleen,strengthening the Spleen and tonifying Qi;when the disease is in the Kidney,nourishing the Kidney and filling up the Essence.

关 键 词：干燥综合征 高球蛋白血症性紫癜 “治血四法” 止血 消瘀 宁血 补虚 

分 类 号：R259.546[医药卫生—中西医结合]