翟文生从伏暑论治过敏性紫癜经验  

Zhai Wensheng′s Experience in Treating Henoch-Sch?nlein Purpura Based on the Theory of Latent Summerheat

作　　者：赵永旺[1,2] 李广[1,2] 翟文生[1,2] ZHAO Yongwang;LI Guang;ZHAI Wensheng(The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou,Henan,China,450000;Pediatric School of Medicine,Henan University of Chinese Medicine,Zhengzhou,Henan,China,450000)

机构地区：[1]河南中医药大学第一附属医院,河南郑州450000 [2]河南中医药大学儿科医学院,河南郑州450000

出　　处：《河南中医》2025年第4期533-537,共5页Henan Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81273803);河南省第三批中医药青苗人才项目{豫卫中医药科教[2024]4号};第七批全国老中医药专家学术经验继承项目{国中医药人教函[2022]76号}。

摘　　要：翟文生教授认为,过敏性紫癜根本病机为正虚邪伏,可从伏暑论治。急性期虽然可见到表证,却非单纯的表证,外感只是诱发因素,伏暑才是发病根本,治疗当表里双解,采用辛凉透表、祛风清热、凉血安络法,方用银翘散加生地黄、牡丹皮、赤芍等。邪气潜伏,并非伏而不变,而是随体质发生改变,素体阳气偏盛者,可转化为暑热病邪,治疗以清热解毒,凉血止血法,方用犀角地黄汤加减;平素阳气偏虚者,热化较缓,表现出湿热证候,治疗需注意湿热所在病位,湿热痹阻关节者,方选四妙散加减;湿热困阻中焦者,方用半夏泻心汤加减;肝胆湿热者,方用龙胆泻肝汤加减;湿热蕴结下焦者,方选小蓟饮子加减。迁延期伏暑伤阴者,治宜滋阴清热,活血散瘀,方选大补阴丸;伏暑伤气者,治以益气摄血为主,方选归脾汤加减;伏暑后期肾气大伤者,治当益肾固摄,方用参芪地黄汤加减。Professor Zhai Wensheng believes that the fundamental pathogenesis of Henoch-Sch9nlein purpura(HSP) lies in deficiency of healthy qi and latent pathogens,which can be treated through the latent summerheat theory.During the acute phase,although external triggers may manifest with exterior syndromes,which are not purely exterior syndromes but rather precipitating factors.Treatment should focus on resolving both exterior and interior pathogens using methods such as releasing the exterior with pungent-cool medicinals,dispelling wind-heat,and cooling blood to stabilize collaterals,exemplified by Lonicera and Forsythia Powder plus Shengdihuang(Radix Rehmanniae),Mudanpi(Cortex Moutan),Chishao(Radix Paeoniae Rubra),etc.Latent pathogens are not static but evolve according to constitutional tendencies.For patients with excessive yang,pathogens may transform into summerheat,so the treatment should focus on clearing heat,detoxifying,cooling blood,and stopping bleeding via Modified Rhinoceros Horn and Rehmannia Decoction.For those with constant yang qi deficiency,the pathogenic heat transforms more slowly,presenting as dampness-heat syndrome.Treatment should target the affected regions:For dampness-heat obstructing joints,Modified Wonderfully Effective Four Powder can be used.For dampness-heat stagnating in the middle energizer,Modified Pinellia Heart-Draining Decoction can be used.For dampness-heat in the liver-gallbladder,Modified Gentian Liver-Draining Decoction can be used.For dampness-heat accumulating in the lower energizer,Modified Field Thistle Drink can be used.In the chronic phase,for Latent summerheat injuring yin,the treat should focus on nourishing yin,clearing heat,activating blood circulation and removing stasis,so Major Yin-Supplementing Pill can be used.For those with severe damage to the kidney qi in the later stage of summer heat exhaustion,Modified Spleen-Restoring Decoction can be used to tonify qi and control bleeding.For those with severe damage to the kidney qi in the later stage of summerheat exhausti

关 键 词：过敏性紫癜 伏暑 翟文生 

分 类 号：R272.725.9[医药卫生—中医儿科学]