国医大师周仲瑛教授从瘀热治疗原发性血小板增多症经验

Experience of TCM master ZHOU Zhong-ying in treating essential thrombocytosis based on stagnated heat

对于原发性血小板增多症,历代医家多以活血化瘀法治之。周仲瑛教授认为本病患者多先天禀赋不足、肝肾亏虚,一方面,血行不畅,停而为瘀;另一方面,阴虚生内热,日积月累,终使瘀热搏结于髓脉血络,形成络热血瘀证;治疗大法为滋阴凉血化瘀,但需辨清各病机证素轻重;临证当详辨血瘀和血热、出血与瘀血、阴伤与血热孰轻孰重;灵活选用血药;消癥化积,精选虫类药。

For the patients with essential thrombocytosis, doctors in the past dynasties mostly use the rule of activating blood and resolving stasis. Professor ZHOU Zhong-ying thinks that the insufficiency of natural endowment and deficiency of liver and kidney is the essential pathogenesis of essential thrombocytosis. On the one hand, the blood flow is not smooth lead to the blood stasis. on the other hand, endogenous heat due to yin deficiency eventually lead tostagnation of blood stasis and heat in bone marrow, vessel, blood and collateral after a long time become to the syndrome of blood stasis due to collateral heat. Treatment method is enrich yin and cooling blood for removing blood stasis. But, it is important to distinguish which one is more serious, between pathogensis and syndrome elements, stasis and heat of blood, hemorrhage and blood stasis, yin injured and blood heat. Moreover, flexible compatibility of blood drugs and activating blood and removing stasis by the selection of insect drugs are important too.