摘要
陈光明教授认为小儿过敏性紫癜的病因具有内外之别,疾病初期外邪侵袭,以邪实为主,风、热、瘀为主要病理因素,以祛邪安络消斑为基本治疗大法,对于风热伤络证治宜祛风清热、凉血安络,予银翘散加减;血热妄行证治宜清热解毒、凉血止血,予犀角地黄汤加减。疾病后期因病久或迁延反复多致虚证,或虚实夹杂,治疗当以扶正为主,兼以祛邪;阴虚火旺证治宜滋阴清热、凉血止血,予犀角地黄汤去水牛角、生石膏加减;气不摄血证治宜健脾益气、摄血止血,予归脾汤加减。陈教授将活血化瘀法贯穿治疗始终,并根据病情的轻重缓急,辨证选方用药,对于病情迁延反复者,又当顾护脾胃,以祛湿为要,重视饮食调理,标本同治,症因兼顾。附案例1则,以资验证。
Professor CHEN Guangming believes that the etiology of pediatric allergic purpura can be categorized into internal and external factors.In the early stage of the disease,external pathogens invade the body,with pathogenic excess as the dominant pattern,where wind,heat,and blood stasis are the primary pathological factors.The fundamental treatment principle is to eliminate pathogens,stabilize the collaterals,and resolve macules.For the pattern of wind-heat injuring the collaterals,the treatment should focus on dispelling wind,clearing heat,cooling the blood,and calming the collaterals,using a modified Yinqiao San(银翘散).For the pattern of hemorrhagic disorder caused by blood-heat,the treatment should emphasize clearing heat,detoxifying,cooling the blood,and stopping bleeding,with a modified Xijiao Dihuang Tang(犀角地黄汤).In the later stages of the disease,prolonged or recurrent conditions often lead to deficiency patterns or a mixture of deficiency and excess.Treatment should prioritize reinforcing healthy qi while eliminating pathogens.For the pattern of yin deficiency with effulgent fire,the approach involves nourishing yin,clearing heat,cooling the blood,and stopping bleeding,using a modified Xijiao Dihuang Tang without Buffalo Horn and Gypsum.For the pattern of qi failing to contain blood,the treatment should strengthen the spleen,boost qi,and restrain blood to stop bleeding,with a modified Guipi Tang(归脾汤).Professor CHEN consistently incorporates blood-activating and stasis-resolving methods throughout the treatment course.He tailors prescriptions based on the severity and urgency of the condition.For cases with prolonged recurrence,he emphasizes protecting the spleen and stomach,prioritizing dampness elimination,and paying close attention to dietary regulation,addressing both the root and the manifestation while considering symptoms and causes.A case example is included for validation.
作者
袁洋
陈光明
马海龙
许璿
杨学会
闫雪
唐悦
YUAN Yang;CHEN Guangming;MA Hailong;XU Xuan;YANG Xuehui;YAN Xue;TANG Yue(Department of Pediatrics,Yancheng Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine,Yancheng,Jiangsu 224001,China)
出处
《中医儿科杂志》
2025年第4期17-20,共4页
Journal of Pediatrics of Traditional Chinese Medicine
基金
江苏省名老中医药专家传承工作室项目(苏中医科教[2021]7号)
江苏省第六期“333高层次人才培养工程”项目(苏人才[2022]1号)。
关键词
过敏性紫癜
儿童
辨证论治
临床经验
陈光明
allergic purpura
children
syndrome differentiation and treatment
clinical experience
CHEN Guangming
