周露 曾英坚

【摘 要】 基于“气能生血、气能摄血”等理论，中医治疗原发免疫性血小板减少症（ITP）的治疗多从气血角度出发。文章以气血角度分别从理论研究、中医辨证论治、临床研究和实验研究四个方面介绍了中医药论治免疫性血小板减少症，得出此治法在提升血小板计数及改善临床症状上有良好疗效。研究指出，气不摄血型ITP患者体内血管活性物质分泌失常，存在血管损伤。表明可以通过从不同中医证型的ITP患者的血管活性物质分泌差异来寻找与ITP特异性的指标，并通过研究中医药调节ITP患者血管活性物质的分泌、修复ITP患者的血管损伤来为今后的治疗提供新思路。

【关键词】 原发免疫性血小板减少症;从气血论治;益气摄血

【中图分类号】R259   【文献标志码】 A    【文章编号】1007-8517（2021）11-0058-04

Abstract：Based on the theory of “Qi generates blood and Qi absorbs blood”， the treatment of immune thrombocytopenia （ITP） is mostly from the perspective of qi and blood. From the perspective of qi and blood， this paper introduces the treatment of immune thrombocytopenia based on TCM theory from four aspects： theoretical research， TCM syndrome differentiation， clinical research and experimental research， and concludes that this treatment has a good effect on improving platelet count and improving clinical symptoms. Some studies have pointed out that the secretion of vasoactive substances in ITP patients is abnormal and there is vascular injury. This indicates that in future studies， specific indicators of ITP can be found from the differences in the secretion of vasoactive substances in ITP patients with different TCM syndromic types， and new ideas for future treatment can be provided by studying the role of TCM in regulating the secretion of vasoactive substances in ITP patients and repairing the vascular damage in ITP patients.

Keywords：Primary Immune Thrombocytopenia;From Qi and Blood Treatment;Qi and Blood Consumption

原發免疫性血小板减少症（Immune thrombocytopenia，ITP）是一种原因不明的获得性自身免疫性疾病，发病机制主要为免疫介导的血小板过度破坏或血小板生成不足，导致外周血血小板计数小于100×109/L[1]。主要临床表现为反复的皮肤黏膜出血、鼻出血、牙龈出血等，女性还表现为月经过多等，是临床上常见的出血性疾病[2]。治疗上西医主要药物有激素、丙种球蛋白、艾曲波帕、利妥昔单抗等[3]。中医药治疗ITP在提升血小板计数及改善出血症状方面有一定的优势[4]。中医中无原发免疫性血小板减少症之病名，根据ITP的临床症状可归属于中医“血证”“葡萄疫”范畴[5]。《景岳全书·杂证谟·血证》中论述到“血本阴精，不宜动也，而动则为病。……