若干同证疾病或状态异病同治的科学基础初探

Scientific Basis of Using Similar Treatment Method for Treating Different Diseases as Identical Syndrome

证、异病同治等是中医学的重要概念,底蕴深厚、临床运用广泛。哮喘、COPD、特应性皮炎等炎症性疾病或状态临床十分常见,其发病机理及现代医学治疗等方面的共性明显,而现代医学干预能力有限。前述疾病或状态中医辨证往往同属肾虚、气虚证型,异病同证同治采用补肾益气理法方药干预,疗效较为明显,其初步机理可能是补肾益气药能够作用于这些炎症性疾病或状态的共性化病理环节,主要是HPA轴和炎性反应网络中心疗效靶位群,其中补肾药主要作用于HPA轴靶位群,而益气药主要作用于炎症反应靶位群,并能调节HPA轴功能和炎症反应之间的异常关系,且补肾药与益气药相互之间有协同作用。

＂Syndrome＂and＂Treating different diseases with same method＂,which are important concepts in Traditional Chinese Medicine （ TCM） ,have profound meanings and are widely used in clinical practice. Chronic inflammatory diseases such as asthma,chronic obstructive pulmonary disease and atopic dermatitis have some similarities in terms of pathogenesis and intervention methods. However, current treatments for these diseases have limitations. According to the theory of TCM,these diseases are usually identified as syndrome ＂Kidney deficiency＂or＂Qi deficiency＂,therefore,treated with the method＂strengthening Kidney and replenishing Qi＂. This is in line with the thought of＂Use similar method to treat different diseases as identical syndrome＂. Strengthening Kidney and replenishing Qi is proved to be effective treatment,based on our preliminary work,this is because strengthening kidney have an impact on HPAA and replenishing Qi on immunity system,and correct abnormal relations. The research proved a synergistic effect between strengthening Shen and replenishing Qi herbs.