首页|从"肝者,凝血之本"探讨原发免疫性血小板减少症的病机与论治思路

从"肝者,凝血之本"探讨原发免疫性血小板减少症的病机与论治思路

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原发免疫性血小板减少症(ITP)归属于中医学"血证""发斑""肌衄"等范畴,临床表现以出血为主,治疗上以防止出血为要.肝脏是调节血液运行的重要脏器.明代章潢《图书编》曰:"肝者,凝血之本",认为肝为凝血之本,主凝血,具有收摄血液、防止出血的功能,为从肝论治ITP提供了良好的理论依据.文章以"肝者,凝血之本"为切入点,论述其内涵主要包括肝气摄血、肝阴凝血和肝主疏泄能防止出血3个方面;ITP病机上以肝之气、血、阴虚为本,虚热、血热、气滞、血瘀为标,可以概括为肝不主凝血;从补肝以止血(益肝气、养肝血、滋肝阴)、凉肝清肝以止血、疏肝化瘀以止血3个方面论治ITP,冀为ITP的防治和诊疗提供新思路.
Discussion on the pathogenesis and treatment approach of primary immune thrombocytopenia from the perspective of'liver is the root of coagulating blood'
Primary immune thrombocytopenia(ITP)belongs to the categories of'bleeding syndrome','Faban','muscle bleeding'in traditional Chinese medicine.Its clinical manifestations are mainly bleeding,and its treatment is to prevent bleeding.The liver is an important organ for regulating blood circulation.The book of Tushubian by ZHANG Huang of the Ming dynasty said:'liver is the root of coagulating blood'.It is believed that the liver is the root of blood coagulation,which is mainly responsible for blood coagulation,has the function of fixing blood and preventing bleeding,and provides a good theoretical basis for the treatment of ITP from the perspective of liver.Taking'liver is the root of coagulating blood'as the starting point,this paper discusses its connotation mainly including three aspects:the qi of liver fix blood,the yin of liver coagulate blood and liver govern regulating to prevent bleeding.The pathogenesis of ITP is based on the deficiency of the qi,blood and yin of liver,and characterized by deficiency heat,blood heat,qi stagnation and blood stasis.ITP is treated from three aspects:tonifying the liver to stop bleeding(benefiting liver qi,nourishing liver blood,nourishing liver yin),cooling the liver to clear the liver to stop bleeding,and soothing the liver to remove blood stasis to stop bleeding,hoping to provide new ideas for the prevention,treatment and diagnosis of ITP.

Primary immune thrombocytopenia(ITP)TushubianLiver governs coagulating bloodTraditional Chinese medicineTherapy

彭名行、黄礼明、朱国庆、尹尚瑾、陈孟豪、左乐

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贵州中医药大学,贵阳 550025

贵州中医药大学第二附属医院,贵阳 550003

原发免疫性血小板减少症 《图书编》 肝主凝血 中医学 治法

贵州省中医药管理局资助项目2022年贵州中医药大学研究生教育创新计划项目2022年贵州中医药大学研究生教育创新计划项目

QZYY-2018-038YCXZRB202210YCXZRB202206

2024

中华中医药杂志
中华中医药学会

中华中医药杂志

CSTPCD北大核心
影响因子：1.135
ISSN：1673-1727
年,卷(期)：2024.39(7)
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