基于“阳化气,阴成形”理论探讨原发免疫性血小板减少症辨治

Based on the theory of“yang transforming qi and yin forming”,the identification and treatment of primary immune thrombocytopenia is discussed

原发免疫性血小板减少症(ITP)是以出血为主要临床表现的获得性自身免疫性疾病。普遍认为ITP为巨核细胞产板不良或(和)机体免疫异常介导的血小板破坏增加,导致血小板数量减少,故ITP关键在于血小板的生成与破坏。ITP属于中医“血证”“紫癜病”范畴,中医对此阐述较多。文章基于“阳化气,阴成形”理论,从生成与破坏角度对ITP的辨治进行探讨,将血小板生成减少与“阴成形”不足相联系,血小板破坏过多与“阳化气”太过相联系,分析得出“血小板生成”属阴精化血范畴,“血小板破坏”属阳气耗散或化物异常范畴,基于此确定将“泻火”“滋阴”等治疗方法应用于临床实践,为探索辨治ITP提供新思路。

Primary immune thrombocytopenia(ITP)is an acquired autoimmune disease with bleeding as the main clinical manifestation.The prevailing view is that the disease is mostly due to a decrease in platelets as a result of poor platelet production by megakaryocytes or(and)increased platelet destruction mediated by abnormalities in the body’s immunity,so the key to this disease is platelet production and destruction.ITP belongs to the category of“blood evidence”and“purpura disease”in Chinese medicine,Chinese medicine also has a lot to say about this.This paper discusses the treatment of ITP based on the theory of“yang transforming qi and yin forming”,and links the reduction of platelet production with the deficiency of“yin forming”and the excessive destruction of platelets with“yang transforming qi”.Based on this,the analysis of“platelet production”belongs to the category of yin essence transforming blood,while“platelet destruction”belongs to the category of yang energy dissipation or abnormalities of chemical compounds,determine the treatment methods of“dipping fire”and“nourishing yin”to be applied in clinical practice,and provide new ideas to explore the treatment of this disease.