以《黄帝内经》为源浅探原发性血小板减少

A Preliminary Exploration of Primary Immune Thrombocytopenia Based on Huangdi Neijing

摘要: 原发免疫性血小板减少症(ITP)是临床常见的出血性疾病，现代医学以糖皮质激素、免疫抑制剂等为主要治疗手段，但存在复发率高、副作用明显等局限。文章以《黄帝内经》中的血证理论为源头，系统梳理原发性血小板减少的中医认识源流，从“阳络伤则血外溢”、“阴络伤则血内溢”等经典论述出发，结合临床实践，将本病分为急性与慢性两大类，急性型以血热妄行为主，含火热炽盛、阴虚内热两证；慢性型以气虚不摄为主，含气不摄血、脾不统血两证，并提出相应的治法方药。研究旨在为原发性血小板减少症的中医辨证论治提供理论依据与临床参考，丰富《黄帝内经》理论在现代血液病中的应用。

Abstract: Primary immune thrombocytopenia (ITP) is a common hemorrhagic disease in clinical practice. Modern medicine mainly treats it with glucocorticoids and immunosuppressants, but there are limitations, such as a high recurrence rate and obvious side effects. Based on the blood syndrome theory in Huangdi Neijing (Yellow Emperor’s Inner Canon), this paper systematically reviews the origin of traditional Chinese medicine (TCM) understanding of primary thrombocytopenia. Starting from classical discussions such as “injury to yang collaterals causes external bleeding” and “injury to yin collaterals causes internal bleeding”, combined with clinical practice, the disease is divided into acute and chronic types. The acute type is mainly characterized by blood heat, causing reckless movement of blood, including two syndromes: exuberant fire-heat and yin deficiency with internal heat. The chronic type is mainly characterized by qi deficiency failing to control blood, including two syndromes: qi failing to control blood and spleen failing to control blood. Corresponding therapeutic methods and prescriptions are proposed. This study aims to provide a theoretical basis and clinical reference for TCM syndrome differentiation and treatment of primary immune thrombocytopenia, and enrich the application of Huangdi Neijing theory in modern hematological diseases.