基于重阳思想探讨“阳虚生瘀”理论在下肢静脉曲张中的应用

Research in the application of the theory of stasis manifestation due to yang deficiency in varicose veins of the lower extremities based on the Chongyang thought

基于《黄帝内经》重阳思想及阳气生理功能与病理表现提出“阳虚生瘀”理论。据下肢静脉曲张病特征特点和发展规律分析,认为“阳虚生瘀”是下肢静脉曲张的根本病机。提出下肢静脉曲张以阳虚不固失化为本,以内生外受之邪为变,以血瘀脉络不通为标,创以扶阳祛邪化瘀为基本治法,并根据本病临床分期不同,侧重灵活治疗。病程初期可温阳益气、兼以行气,病程中期可扶阳助正、祛邪化瘀,病程后期可化瘀生肌、培元固本,选方用药以扶阳化气为本,以助正祛邪为首,以活血化瘀为辅,遵循整体观念循证治疗。

Based on the idea of Chongyang in Huangdi Neijing and the physiological function and pathological manifestation of yang qi,the theory of"stasis manifestation due to yang deficiency"is proposed.According to the analysis of the characteristics and developmental patterns of varicose veins of the lower extremities,it is believed that"stasis manifestation due to yang dificiency"is the fundamental pathogenesis of varicose veins of the lower extremities.It is proposed that varicose veins of the the lower extremities should be based on the principle of loss of control due to yang deficiency and transformation,with endogenous pathogenic factors and exogenous evils as changes,and blood stasis and meridian obstruction as the symptoms.And the basic treatment method for this disease is to support yang,eliminate pathogenic factors,and expelle blood stasis.According to the different clinical stages of the disease,flexible treatment is emphazized.In the early stage of the disease,it is possible to warm yang and benifite qi,while also activating qi-flowing.In the middle stage of the disease,it is possible to benifite yang and strengthen vital qi,and eliminate pathogen and expell blood stasis.In the late stage of the disease,it is possible to expell blood stasis and promote granulation,and reinforce the vital essence and consolidate body resisitance.The selection of the prescriptions and the use of the drugs should be based on the principle of benifiting yang and transforming qi,with the primary focus on strengthening vital qi and eliminating pathogen,and the auxiliary focus on promoting blood circulation for removing blood stasis.This article proposes evidence-based treatment based on the holistic approach.