1.浙江中医药大学 杭州 310053
2.浙江中医药大学附属第一医院
3.北京中医药大学东直门医院
王依丹,女,在读硕士生
# 叶宝东,男,博士,教授,主任医师,博士生导师,主要研究方向:中西医结合治疗血液病,E-mail:13588453501@163.com
纸质出版日期:2023-08-30,
收稿日期:2023-02-22,
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王依丹, 谢二帅, 刘文宾, 等. 探讨从肺论治原发免疫性血小板减少症[J]. 北京中医药大学学报, 2023,46(8):1172-1177.
WANG Yidan, XIE Ershuai, LIU Wenbin, et al. Exploring TCM treatment of primary immune thrombocytopenia based on the lung[J]. Journal of Beijing University of Traditional Chinese Medicine, 2023,46(8):1172-1177.
王依丹, 谢二帅, 刘文宾, 等. 探讨从肺论治原发免疫性血小板减少症[J]. 北京中医药大学学报, 2023,46(8):1172-1177. DOI: 10.3969/j.issn.1006-2157.2023.08.017.
WANG Yidan, XIE Ershuai, LIU Wenbin, et al. Exploring TCM treatment of primary immune thrombocytopenia based on the lung[J]. Journal of Beijing University of Traditional Chinese Medicine, 2023,46(8):1172-1177. DOI: 10.3969/j.issn.1006-2157.2023.08.017.
原发免疫性血小板减少症(ITP)是临床上最常见的出血性疾病,属中医学“血证”“紫癜”等范畴。古今医家多从脾或脾肾论治,亦有少数医家从心、肝论治。基于临证经验,发现从肺论治ITP也往往能取得较好的疗效。本文通过查阅大量古代医籍和现代文献,从“肺为血脏,助化血液”“金水相生,共化精血”的理论出发,系统提出了“肺气助脾统摄血液”及“肺气助心运行血液”的肺调控血液的观点。总结ITP的中医病因病机,为肺脏受邪、肺气不足、阳虚外寒,提出补益肺气、清热泻肺、滋阴降逆、温肺散寒的治疗法则,并推荐具体方药。从肺论治为中医治疗ITP提供了新的研究思路。
Primary immune thrombocytopenia (ITP) is the most common hemorrhagic disease. In traditional Chinese medicine (TCM)
it belongs to the category of "blood syndrome" or "purpura." Ancient and modern physicians mostly treat it focusing on the spleen or spleen and kidney (TCM terms
not completely the same as the anatomical concepts)
and there are also a few doctors who treat it based on the heart or liver (see above). In clinical practice
we found that treatment of ITP based on the lung often achieved better clinical efficacy. Based on ancient medical books and modern literature
we systematically put forward a new viewpoint of regulating blood through "lung qi aiding spleen to control blood" and "lung qi helping heart to transport blood" based on the theory of "the lung is a blood-zang which can transform the blood" and "Jin-shui theoretical and mutual transformation between essence and blood." We also summarize three etiology and pathogenesis theories
lung qi affected by evil
lung qi deficiency
and yang deficiency with external cold manifestation. The four principles of replenishing and restoring lung qi
clearing heat and purging lung
nourishing yin and clearing lung
and warming lung for dispelling cold are proposed to treat ITP and we recommend classical prescriptions. This article broadens the scope of TCM treatment of ITP.
原发免疫性血小板减少症肺血证病机辨证
primary immune thrombocytopenialungblood syndromepathogenesissyndrome differentiation
中华医学会内科学分会,王建祥,张奉春,等. 中国成人血小板减少症诊疗专家共识[J].中华内科杂志,2020, 59(7):498-510.
S AUDIA, M MAHÉVAS, M SAMSON, et al. Pathogenesis of immune thrombocytopenia[J]. Autoimmun Rev, 2017, 16(6):620-632.
N COOPER, W GHANIMA. Immune Thrombocytopenia[J]. N Engl J Med, 2019, 381 (10):945-955.
J BUSSEL, N COOPER, R BOCCIA, et al. Immune thrombocytopenia[J]. Expert Rev Hematol, 2021, 14(11):1013-1025.
陈信义,杨文华. 中医血液病学[M].北京:中国中医药出版社,2019:111.
郭雪洋. 清热凉血方配合西药治疗复发免疫性血小板减少症疗效研究[J].陕西中医,2018, 39(8):1091-1093.
董照,王佩,穆吉兴,等. 清热凉血组方干预免疫性血小板减少症临床研究[J].中华保健医学杂志,2018, 20(6):474-477.
张玲,陈科,张雅月,等. 健脾益气摄血方治疗免疫性血小板减少症临床疗效及其机制研究[J].北京中医药大学学报,2020, 43(4):343-352.
魏丢,唐旭东,许勇钢,等.麻柔教授基于扶阳思想辨治免疫性血小板减少性紫癜经验总结[J].陕西中医,2021,42(9):1279-1281.
苏冬青.调肝扶脾法治疗特发性血小板减少性紫癜的临床研究[D].广州:广州中医药大学,2010.
王忠武,于天启,扬宏光. 祛风凉血法治疗特发性血小板减少性紫癜的理论基础[J].广州中医药大学学报,2004, 21(2):91-93.
徐皓,陈伟,鲍计章,等. 中医药治疗原发免疫性血小板减少症用药规律数据挖掘研究[J].中国中医药信息杂志,2021, 28(4):41-46.
杨阳,傅丽娟,陈滨海,等. 周郁鸿教授从脾肾论治免疫性血小板减少症的经验总结[J]. 浙江中医药大学学报,2020, 44(1):68-71.
田梅,张伟.论肺为血脏[J].中华中医药杂志,2014,29(3):680-682.
张积思,徐江雁. “肺朝百脉”理论研究评析[J].中华中医药杂志,2020, 35(11):5367-5369.
李天天,褚雨霆,杨璐,等. 脾主统血理论的内涵与拓展[J].中医药信息,2015, 32(6): 99-102.
李天天,侯丽,张雅月,等. 从脾论治免疫性血小板减少性紫癜的理论基础与临床实践[J].北京中医药,2015, 34(4):304-306.
E LEFRANÇAIS, G ORTIZ-MUÑOZ, A CAUDRILLIER, et al. The lung is a site of platelet biogenesis and a reservoir for haematopoietic progenitors[J]. Nature, 2017, 544(7648):105-109.
E EVREN, E RINGQVIST, KP TRIPATHI, et al. Distinct developmental pathways from blood monocytes generate human lung macrophage diversity[J]. Immunity, 2021,54(2): 259-275.
张明辉,张丽娜,吴洁,等. 成人原发免疫性血小板减少症的中医认识与治疗[J].北京中医药,2020, 39(6):578-580.
朱文伟,陈信义,周永明. 成人原发免疫性血小板减少症中医诊治专家共识[J].中华中医药杂志,2022, 37(4):2129-2133.
王伟涛,吴深涛,刘宝山. 免疫性血小板减少症的中医病因病机浅析[J].中医药学报,2016, 44(2):8-9.
黄茜,金朝晖. 从“木火刑金”论治支气管扩张伴咯血[J].中国民族民间医药,2022, 31(5): 107-109.
唐宗海.血证论[M].魏武英,李佺,整理.北京:人民卫生出版社,2009.
王洪志,朱世荣,胡晓梅,等. 气不摄血证免疫性血小板减少症患者血管活性物质及相关炎症因子变化与临床意义[J].世界科学技术—中医药现代化,2020, 22(3):897-902.
曲文闻,宋敏敏,王玥,等. 胡晓梅主任温阳化气治疗紫癜病学术思想探讨[J].国际中医中药杂志,2014, 36(2):176-179.
梅恒,胡豫. 新型冠状病毒肺炎(COVID-19)患者出凝血功能障碍病因分析及诊治策略[J].中华血液学杂志,2020,41(3):185-191.
周澧,秦川. 2019新型冠状病毒肺炎凝血异常机制与中医血瘀证候[J].中国比较医学杂志,2022, 32(1):89-96.
曲志刚,方炳木,刘永华,等. 增血汤联合生血散对特发性血小板减少性紫癜患者血小板相关抗体IgG的影响[J].中华中医药学刊,2013, 31(9):1848-1849.
周郁鸿,吴迪炯,沈一平,等. 慢性特发性血小板减少性紫癜“治从气阴”[J].浙江中医药大学学报,2009, 33(5):693-694.
张宇,钱丽丽,陈颖,等. 益气滋阴方对免疫性血小板减少症患者外周血Treg及Foxp3影响的临床观察[J].浙江中医药大学学报,2017, 41(3):215-218.
张白雪,刘绍能. 从肺辨治便秘思路探讨[J].北京中医药,2021, 40(9):1008-1010.
孙香颖,胡冬菊,王永敏,等. 胡冬菊教授中医辨治免疫性血小板减少症的经验[J].世界中西医结合杂志,2020, 15(11):2028-2031.
代彦林,张霞,秦亚丹,等. 丁樱教授从“伏毒”论治难治性免疫性血小板减少症经验[J].时珍国医国药,2020, 31(7):1793-1794.
郑春梅,麻柔. 麻柔治疗免疫性血小板减少症经验总结[J].中国临床医生杂志,2015, 43(9):89-91.
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