病证结合视域下的血热证生物学实质与凉血中药作用机制研究  

Exploration of biological essence of blood heat syndrome and mechanism of blood-cooling traditional Chinese medicine from combination of disease and syndrome

作　　者：孙费悦 荆志伟[2] 葛金文 梅志刚 SUN Fei-yue;JING Zhi-wei;GE Jin-wen;MEI Zhi-gang(School of Integrated Chinese and Western Medicine,Hunan University of Chinese Medicine,Changsha 410208,China;Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences,Beijing 100700,China;Hunan Academy of Chinese Medicine,Changsha 410006,China)

机构地区：[1]湖南中医药大学中西医结合学院,湖南长沙410208 [2]中国中医科学院中医临床基础医学研究所,北京100700 [3]湖南省中医药研究院,湖南长沙410006

出　　处：《中国中药杂志》2025年第4期985-993,共9页China Journal of Chinese Materia Medica

基　　金：国家自然科学基金项目(82174167);国家中医药管理局青年岐黄学者培养项目;湖南省“十四五”第二批中医药学科带头人培养项目。

摘　　要：血热证是中医血证的主要亚型之一,临床以出血和热象为主要审证要点,多以凉血法为主进行辨证论治。病证结合视域下对血热证相关研究文献综合分析发现,血热证生物学实质主要与免疫应答异常、氧化应激、凝血功能障碍、性激素分泌紊乱、能量代谢异常等病理环节关系密切,常见于系统性红斑狼疮、银屑病、紫癜性自身免疫性皮肤病,中枢高热性疾病,单核细胞增多症、新型冠状病毒感染等感染性疾病及妇科出血性疾病。凉血中药作为临床治疗血热证的首选药物,通常还配伍活血化瘀药、滋阴药、息风药等协同发挥凉血之功,究其机制可能与减轻炎症反应,抑制氧化应激,改善凝血平衡及代谢紊乱,调节性激素分泌,减轻变态反应等有关。该文系统探析了血热证的生物学实质,试图阐明凉血方药的作用靶点及其潜在机制,为中医药临床防治血热证相关疾病奠定基础。Blood heat syndrome,one of the main subtypes of blood syndrome in traditional Chinese medicine(TCM),is mainly diagnosed by bleeding and heat manifestations and treated by the blood-cooling method.The biological essence of blood heat syndrome has not been elucidated yet,and there is a lack of systematic research on the potential mechanisms underlying the blood-cooling method.The biological essence of blood heat syndrome is closely related to abnormal immune response,oxidative stress,coagulation dysfunction,endocrine disorders,abnormalities in energy metabolism and so on.Blood heat syndrome is common in autoimmune skin diseases(such as systemic lupus erythematosus,psoriasis,and purpura),central hyperthermia,infectious diseases(such as infectious mononucleosis and COVID-19),and hemorrhagic diseases in gynecology.As the primary clinical therapy for blood heat syndrome,blood-cooling TCM is usually combined with the TCM with effects of activating blood and resolving stasis,nourishing Yin,and extinguishing wind to play the role of cooling blood.The mechanisms of above therapies may be attributed to reducing inflammation,inhibiting oxidative stress,restoring the balance of blood coagulation and metabolism,regulating the secretion of sex hormones,and alleviating allergic reactions.This article systematically explores the biological essence of blood heat syndrome and elucidates the targets and underlying mechanism of the blood-cooling method,laying a scientific foundation for the clinical application of TCM in the prevention and treatment of diseases associated with blood heat syndrome.

关 键 词：血热证 凉血中药 生物学实质 病证结合 炎症 

分 类 号：R25[医药卫生—中医内科学]