试析“血不利则为水”及其儿科肺系疾病临床应用举隅

Analysis on “Blood Stasis Leading to Edema” and Its Pediatrics Lung Diseases

“血不利则为水”出自《金匮要略·水气病篇》,为张仲景辨析妇人经水不利而提出的著名论断,并基于该论断确立活血利水法,创制活血化瘀方剂,治疗血分病。其后历代医家奉此为证治准绳,不断验证、发挥,丰富了其学术内涵,形成其理论体系,中西医结合理论研究表明,“血不利则为水”的主要病理改变为血液循环障碍、血液组分及血液流变状态的变化。任何的血液微循环障碍的现象均可视为“血不利”。中西医结合方法对小儿肺系疾病的实验研究表明,肺经热证多属现代医学呼吸系统疾病范畴,其病理表现初期以呼吸道炎症表现与神经-血管反应为主,局部病理表现为充血与水肿,随着卫气营血或三焦的传变规律,可表现为炎症反应的渗出、吸收、局部纤维化等病理表现、发展进程,与“血不利则为水”的现代病理表达基本吻合,作者探索“血不利则为水”理论在儿科肺系疾病临床应用经验表明活血以利水法论治幼科肺系疾病当有一席之地。

“Blood stasis leading to edema” is from Jingui Yaolue·Water Qi Disease Chapter,a famous assertion made by ZHANG Zhongjing to identify women with unfavorable menstrual water.Based on this assertion, he established the method of promoting blood circulation and promoting diuresis, and created a formula to activate blood circulation and resolve blood stasis to treat blood disorders.Subsequent generations of physicians have taken this as a guideline for treatment and have continuously verified and exerted it, enriching its academic connotation and forming its theoretical system.The research on the combined theory of traditional Chinese and Western medicine shows that the main pathological changes of “blood stasis leading to edema” are blood circulation disorders, changes in blood components and blood rheological status.Any phenomenon of blood microcirculation disorder can be regarded as “blood stasis leading to edema”.The experimental study on the pediatric lung diseases by combining traditional Chinese and Western medicine shows that the heat in lung meridian mostly belongs to the category of respiratory system diseases in modern medicine.The pathological manifestations are initially characterized by inflammatory manifestations of the respiratory tract and neurovascular reactions.The local pathological manifestation is congestion and edema, and with the transmission pattern of Wei-Qi-Ying-Blood or Sanjiao, the pathological manifestation and development of inflammatory reaction such as exudation, absorption and local fibrosis can be manifested.This is basically consistent with the modern pathological expression of “blood stasis leading to edema”.The author′s experience of exploring the theory of “blood stasis leading to edema” in the clinical application of pediatrics lung diseases shows that the treatment of activating blood and promoting water system should have a place.