血小板减少性紫癜辨证施治规律若干问题探要

Discuss about Treatment Based on Syndrome Differentiation for Idiopathic Thrombocygtopenic Purpura (ITP)

根据对检索到的近10年来中医药治疗血小板减少性紫癜文献资料273篇进行了分析,认为该病的病因病机为本虚标实,虚实错杂。本虚以气虚为主,标实以“热毒”、“血瘀”常见。辨证分型以血热妄行、气不摄血、阴虚火旺、脾气虚、瘀血阻络等为其主要证型。用药以补益药、清热泻火药、清热凉血药、止血药、活血祛瘀药、清热燥湿药为主。本文对该病的辨证施治的若干问题作了一些研究和探讨。

Objective：To discuss about some problems of treatment based on syndrome differentiation for ITP. Methods： To study treatment of Chinese herbs to ITP, 237 articles in recent 10 years are retrieved and analysed. Results ： The pathogenic mechanism of traditional Chinese Medicine （TCM） of ITP is asthenia in the root and in the branch, or mixture of asthenia and sthenia. However asthenia of Qi is the main reason in the root, sthenia in the branch is heat poison and blood stasis. It is differentiated into failure of blood to flow in the vessel due to heat. Failure of Qi to govern blood. Flaring of fire due to yin - asthenia, asthenia of splenic Qi, or blood stasis obstructing collaterals etc. Chinese herbs to treat this disease are mainly restorative drugs, heat clearing and blood - cooling drugs, stopping bleeding drugs, activating blood to eliminate stagnation drugs, or heat - clearing and dampness - drying drugs. Conclusion ： Chinese herbs are obviously effective to ITP by treatment based on syndrome differentiation.