白细胞减少症中医诊疗经验辑要

Experience summary of diagnosis and treatment of TCM in leukopenia

关键词:  白细胞减少症  虚劳  温病  病因病机  辨证论治

Key words:  leucopenia  consumptive disease  warm disease  etiology and pathogenesis  syndrome differentiation and treatment

摘要:

白细胞减少症是由于各种病因引起的一组临床综合征。可归属于中医学的“虚劳”、“温病”等病证范畴。其病机变化虽多，但不外气血亏虚、阴阳失调，心、肝、脾、肾机能受损，其中脾肾两虚为其发病关键，虚、热、瘀、湿为其主要病理表现。依据临床证候，四诊合参，结合八纲、脏腑辨证，分为气血两虚、脾肾阳虚、肝肾阴虚、毒瘀互结四型辨证论治，气血两虚、阴阳失调，脏腑功能失常为本，正虚不固，六淫外袭而反复发热、感染为标，其中脾肾两虚为其发病关键，故治疗当以扶正兼祛外邪为基本法则。治疗上以补气养血、健脾补肾为本，以虚、热、瘀、湿为标，辨证论治与辨病论治的有机结合，中西医优化选择。

Abstract:

Leukopenia is a group of clinical syndrome induced by various causes. It can belong to the category of "consumptive disease", "warm disease" of TCM etc. Although the change of its pathogenesis is manifold, but it is mainly related to Qi and blood deficiency, imbalance of Yin and Yang, the functional impairment of heart, liver, spleen, kidney. Among them, the spleen and kidney deficiency is the key of the pathogenesis and the deficiency, heat, blood stasis, wet are the main pathological manifestation. According to the clinical syndromes and the comprehensive analysis of the data gained by the four methods of diagnosis, combining with the eight principal syndromes, Zang and Fu syndrome differentiation, it was divided into four types of syndrome differentiated treatment, such as deficiency of both Qi and blood, Yang deficiency of spleen and kidney, Yin deficiency of liver and kidney, reciprocal combination of poison and blood. The deficiency of both Qi and blood, imbalance of Yin and Yang, dysfunction of Zang and Fu are the origin; deficiency of vital Qi, external invasion of six climate exopathogens with recurrent heat and infection are the superficiality. Among them, deficiency of both spleen and kidney is the key pathogenesis, so the basic rule of treatment should be strengthening the body resistance to eliminate pathogenic factors. In the treatment, invigorating vital Qi and nourishing blood, strengthening the spleen and tonifying the kidney are the main therapeutic method, taking deficiency, heat, stasis and dampness as the superficiality. The organic combination of syndrome differentiated and disease differentiated treatment and optimized choice of Chinese and Western medicine are all very important.