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国医大师丁樱论治儿童难治性过敏性紫癜经验

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新感为标、伏邪为本是难治性过敏性紫癜的根本病机。该病可分为发病期和间歇期,两个分期的病因病机虽有序贯性但却明显有异。发病期乃新感引动伏邪,间歇期为邪气内伏、络脉损伤。本病的辨治关键是分期序贯论治,新感引动伏邪而发病者,治应新感、伏邪兼顾,邪伏脉络者应予僵蚕、地龙等搜风通络之品;气阴虚者补气养阴;络脉瘀阻者予活血化瘀之品,并根据阳络、阴络(脾络、肾络、筋络等)等伏邪传舍不同灵活应用。疾病间歇期伏邪留滞、正气亏虚或络脉损伤为基本病机,故治疗以扶正搜邪为主,法同新感引动伏邪之治则,只是此时新感已祛,正气亏虚较著,注意祛伏邪而不伤正的原则即可。
Experiences of National Master of Chinese Medicine Dingying in Treatment of Refractory Allergic Purpura in Children
The underlying pathogenesis of refractory allergic purpura is new infection can be showed by the symptom and the latent evil factor is the root cause.The disease can be divided into onset and intermittent phases,and the etiology and pathogenesis of the two pha-ses are obviously different,although there is a consistency in the order.In the onset stage,the new sensation attracts and encourage the evil factor,and in the intermittent stage,the evil factor is hidden within the body,with the meridian being damaged.The key to the treat-ment of this disease is the staging of the sequential treatment.For the first case,the treatment should be focus on both the new and old evil factors.For those who have evil ambushes in the meridians and collaterals,drugs to search Wind and clear the collaterals such as Jiangcan(Stiff silkworm)and Dilong(Lumbricus)should be used;for those with deficiency of Qi and Yin,Qi should be tonified to nourish Yin;and for those with stagnation of the collaterals,drugs to activate blood circulation and remove blood stasis should be given.All drugs should be applied flexibly according to the differences in the transmission of ambushes in the Yang collaterals and the Yin col-laterals(the Spleen collaterals,Kidney collaterals,and the tendon collaterals,etc.).For the second case,the treatment should be tonify-ing the Zheng Qi and dispelling the evil factors since the basic mechanism of the disease is the stagnation of the latent evil factors,Zheng Qi deficiency and the damage to the collaterals during the intermittent period of the disease.The treatment principle is similar to that of the first case,but Zheng Qi should be protected more carefully since it is rather weak than before.

refractory allergic purpura in childrenstaged and sequential treatmentsearching for Wind and dredging collateraltonifying Qi and nourishing Yininvigorating blood circulation and removing blood stasisDing YingNation Master of Chinese Medicine

闫晓宇、任献青、陈文霞、张霞、丁樱、闫永彬

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河南中医药大学,河南郑州 450046

河南中医药大学第一附属医院/河南省中西医结合儿童医院,河南郑州 450000

儿童难治性过敏性紫癜 分期序贯论治 搜风通络 补气养阴 活血化瘀 丁樱 国医大师

2025

中医学报
河南中医药大学,中华中医药学会

中医学报

影响因子:1.264
ISSN:1674-8999
年,卷(期):2025.40(1)