秦曼教授辨治小儿过敏性紫癜经验

Professor Qin Man’s Clinical Experience in the Pattern Differentiation and Treatment of Henoch-Schönlein Purpura in Children

摘要: 过敏性紫癜是儿童期常见的毛细血管变态反应性疾病，其急性期发病急骤，常以血热妄行证最为多见。秦曼教授从事中医儿科临床数十载，认为小儿为“纯阳之体”，感邪极易入里化热，热灼血络，迫血妄行，是本病急性期的核心病机。在治疗上，秦教授主张清热解毒、凉血消斑、佐以化瘀的核心治法，常以犀角地黄汤加减化裁。同时，强调在苦寒清解之中不忘顾护小儿脾胃，用药轻灵，标本兼顾。文章系统总结秦曼教授辨治小儿过敏性紫癜(血热妄行证)的临床经验，并附典型验案1则，以资临床验证与参考。

Abstract: Henoch-Schönlein purpura (HSP) is a common allergic microvascular disease in childhood, characterized by an acute and rapid onset during the acute phase, in which the pattern of reckless blood flow due to blood heat is most frequently encountered. With decades of clinical practice in Traditional Chinese Medicine (TCM) pediatrics, Professor Qin Man posits that children possess a “pure Yang constitution”, whereby contracted pathogenic factors easily enter the interior and transform into heat. This heat scorches blood collaterals and forces reckless extravasation of blood, constituting the core pathogenesis of the acute stage. Therapeutically, Professor Qin advocates the core principles of clearing heat, resolving toxicity, cooling blood to dissipate macules, and adjuvant resolving of blood stasis, frequently employing modified Xijiao Dihuang Decoction (Rhinoceros Horn and Rehmannia Decoction). Concurrently, she emphasizes safeguarding the pediatric spleen and stomach amidst the application of bitter-cold medicinals, ensuring light and agile prescription while addressing both root and branch causes. This paper systematically summarizes Professor Qin Man’s clinical experience in the pattern differentiation and treatment of pediatric HSP (pattern of reckless blood flow due to blood heat) and presents one typical proven case to provide valuable reference and validation for clinical practice.