| 何志晨,徐浩田,李睿,等.基于伏气温病理论探讨组织细胞坏死性淋巴结炎的诊疗思路[J].浙江中医药大学学报,2024,48(3):282-287. |
| 基于伏气温病理论探讨组织细胞坏死性淋巴结炎的诊疗思路 |
| Explore the Diagnosis and Treatment of Histiocytic Necrotizing Lymphadenitis Based on Insidious Pathogen Warm Disease Theory |
| DOI：10.16466/j.issn1005-5509.2024.03.005 |
| 中文关键词: 组织细胞坏死性淋巴结炎 菊池病 伏气温病 伏邪 少阳三焦 膜原 祛邪扶正 |
| 英文关键词: histiocytic necrotizing lymphadenitis Kikuchi-Fujimoto disease insidious pathogen warm disease latent pathogen Shaoyang tri-Jiao Moyuan supporting healthy Qi and eliminating the evil |
| 基金项目:国家中医药管理局第五批全国中医优秀人才研修项目(国中医药办人教函﹝2022﹞1号)；第六批北京市中医药专家学术继承研修项目(京中医科字﹝2021﹞169号)；北京市中医局仲景国医研修班项目(第三期)(京中医科字﹝2016﹞114号) |
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| 中文摘要: |
| [目的] 基于伏气温病理论，探讨组织细胞坏死性淋巴结炎(histiocytic necrotizing lymphadenitis，HNL)的病因病机和诊治思路。[方法] 基于古代医籍对伏气温病理论的阐述和HNL的现代研究，分析该病的病因病机、症状特点及传变规律，总结其治疗原则，并报道医案一则予以佐证。[结果] HNL的病机以正虚邪伏为主，表现为在正虚基础上，外感邪气伏于膜原，阳郁化热，外发少阳三焦，内生痰瘀浊毒为病。治疗以扶正祛邪为法，重在祛邪，针对伏邪、郁热和病理产物内生三个病机环节，制定疏利透达、祛邪清热和清理夹邪、解毒散结的治疗原则；扶正重在顾护气阴和愈后调养，预防余邪复遗。所举医案为应用伏气温病理论治疗HNL一例，证属湿热毒蕴、痰瘀互结，先后方选升降散合三仁汤、甘露消毒丹治疗，随证加减，效果显著。[结论] 从伏气温病理论探讨HNL的诊治思路具有临床实用意义，可为诊治HNL提供新思路和方法。 |
| 英文摘要: |
| [Objective] To explore the etiology， pathogenesis and clinical treatment of histiocytic necrotizing lymphadenitis(HNL) based on the insidious pathogen warm disease theory. [Methods] To analyze the etiology， pathogenesis， characteristics of symptoms and transmission of the disease in Chinese medicine， and summarize the treatment principles based on the descriptions about insidious pathogen warm disease in ancient literature and modern researches on HNL， and cite a clinical case for verification. [Results] The pathogenesis of the HNL is mainly characterized by deficient healthy Qi leading to latent evil. The specific manifestation is that exogenous evils are latent in the Moyuan， which causes Yang Qi to be blocked and depressed and turns into heat. Evil heat spreads from the Moyuan to the Shaoyang tri-Jiao， leading to the generation of phlegm， static blood， turbid evil and toxin in the body， which in turn leads to disease. In terms of treatment， supporting healthy Qi and eliminating the evil is regarded as the law of treatment， and the emphasis is eliminating the evil. Aiming at the three pathogenetic links of latent evil， depressed heat and internal production of pathological products， the following treatment principles are formulated: expelling evils from Moyuan， dredging tri-Jiao and promoting the flow of Qi to make the evil heat go out， clearing away endogenous pathological products， removing toxin and dispersing knots. The focus of supporting healthy Qi is the protection of Qi and Yin as well as recuperation after recovery， which prevents evil Qi from remaining and causing the disease to reoccur. The medical case cited was a patient with HNL treated by applying the theory of insidious pathogen warm disease. Damp-heat and toxin brewing， phlegm combined with static blood was the traditional Chinese medicine(TCM) pattern of this case. The the prescriptions were based on Shengjiang Powder combined with Sanren Decoction， and Ganlu Xiaodu Pill successively， added and subtracted according to the syndrome， and the case achieved a significant effect. [Conclusion] The effect of treating HNL based on the insidious pathogen warm disease theory is quite good， which can provide new ideas and methods for the diagnosis and treatment of HNL. |
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