痰、瘀关系病机理论发微与相关治疗方案的优化

The Development of the Pathogenesis Theory of Phlegm and Blood Stasis and the Optimization of Related Treatment Plans

[目的]通过对痰、瘀关系的深入探讨,促进相关治疗方案的优化。[方法]通过查阅痰、瘀关系病机理论的中医学文献,剖析痰、瘀病机的共性特征以及在致病先后、致病部位与相兼致病上的区别,并提出相应的优化治疗方案。[结果]痰、瘀致病具有共性特征,"痰瘀交阻"乃痰、瘀病证之后的"久久之病"的病机,痰性胶固、瘀兼痰之性,痰未必兼瘀、瘀必兼痰,痰瘀病位不同、痰在瘀先。痰瘀交阻治以化痰祛瘀,治瘀必兼化痰,治痰则未必兼用化瘀,治痰在治瘀之先。[结论]痰、瘀、痰瘀交阻是中医临床疑难杂证的重要病机,痰瘀并治、化痰祛瘀兼用具有盲目性与笼统性,对其治疗方案的优化——精准化、精细化,必将有效地提高痰、瘀病证临床治疗的针对性与疗效。

[Objective] Through in-depth discussion of the relationship between phlegm and blood stasis, to promote the optimization of related treatment plans. [Methods] By consulting the literature of traditional Chinese medicine(TCM) on the pathogenesis theory of the relationship between phlegm and blood stasis, this paper analyzed the common characteristics of the pathogenesis of phlegm and blood stasis, as well as the differences in the order of disease, the location of disease and the concurrent disease, and put forward the corresponding optimal treatment plan. [Results] The pathogenesis of phlegm and blood stasis has common characteristics. "Phlegm and blood stasis obstruction" is the pathogenesis of "long-term disease" after the syndrome of phlegm and blood stasis. The nature of phlegm is gelatinous, blood stasis has the character of phlegm. Phlegm may not be combined with blood stasis,while blood stasis must be combined with phlegm. The location of phlegm and blood stasis is different, and phlegm comes before blood stasis. The treatment of phlegm and blood stasis is to resolve phlegm and remove blood stasis. The treatment of blood stasis must be combined with resolving phlegm,while the treatment of phlegm may not be combined with removing blood stasis. [Conclusion] Phlegm, blood stasis, phlegm and blood stasis obstruction are the important pathogenesis of TCM clinical difficult miscellaneous diseases. The combination of phlegm and blood stasis and the combination of resolving phlegm and removing blood stasis in treatment are blind and general. The optimization of its treatment scheme, precision and refinement, will effectively improve the pertinence and efficacy of clinical treatment of phlegm and blood stasis.