国医大师皮持衡基于“风血同治”辨治过敏性紫癜经验

Chinese medicine master PI Chiheng’s experience in diagnosing and treating Henoch-Schönlein purpura based on the principle of“treating wind and blood simultaneously”

关键词:  风血同治  过敏性紫癜  中医药治疗  皮持衡  名医经验

Key words:  treating wind and blood simultaneously  Henoch-Schönlein purpura  traditional Chinese medicine treatment  PI Chiheng  famous doctor experience

摘要:

过敏性紫癜作为一种常见的血管炎性疾病，属中医“肌衄”“紫斑”“紫癫风”“葡萄疫”等范畴。皮持衡教授认为，该病核心病机在于“风邪袭络，扰血动血；血热妄行，溢于脉外；瘀血阻络，新血难安；久伤气阴，虚实夹杂”，风、热、瘀、虚相互交织，贯穿疾病始终。据此，皮教授主张“祛风宁络、清热解毒、凉血化瘀、补虚和络”为一体的“风血同治”之法，强调在疾病不同阶段，辨明风、热、瘀、虚之孰轻孰重，动态调整治则与方药。笔者将从病因病机、辨证分型、治则治法、方药运用、临证特色及典型医案等方面，基于“风血同治”浅析皮持衡教授辨治本病的独特经验，以期为中医临床提供有益借鉴。

Abstract:

As a common vasculitic disorder，Henoch-Schönlein purpura（HSP）falls under the categories of“muscular bleeding” “purpura”“purpura wind”and“grape-like epidemic fever”in traditional Chinese medicine（TCM）. Professor PI believes that the core pathogenesis of the disease lies in“wind pathogens attacking the collaterals and disturbing the blood；heat in the blood causing reckless movement and extravasation；blood stasis obstructing the collaterals and preventing new blood from settling；and prolonged illness damaging qi and yin，resulting in a complex condition of deficiency and excess”. Wind，heat，stasis，and deficiency are interwoven throughout the course of the disease. Accordingly，Professor PI advocates an integrated approach of“treating wind and blood simultaneously”，which includes“expelling wind and calming the collaterals，clearing heat and detoxifying，cooling the blood and resolving stasis，as well as tonifying deficiency and harmonizing the collaterals”. He emphasizes the importance of identifying the relative severity of wind，heat，stasis，and deficiency at different stages of the disease and dynamically adjusting treatment principles and prescriptions. This article will analyze Professor PI Chiheng’s unique experience in the differentiation and treatment of this disease based on the“treating wind and blood simultaneously”principle，from the perspectives of etiology and pathogenesis，syndrome differentiation，treatment principles and methods，application of formulas，clinical characteristics，and typical case studies，aiming to provide valuable insights for clinical practice in TCM.