[1]吕勃川,张百亮,张美君,等.名中医赵钢基于“卫气营血”论治下肢动脉硬化闭塞症经验[J].陕西中医,2025,46(10):1404-1408.[doi:DOI:10.3969/j.issn.1000-7369.2025.10.021]
　LYU Bochuan,ZHANG Bailiang,ZHANG Meijun,et al.Famous doctor ZHAO Gang’s approach to treating lower extremity arteriosclerosis obliterans based on the wei-qi,ying-qi,and blood theory[J].,2025,46(10):1404-1408.[doi:DOI:10.3969/j.issn.1000-7369.2025.10.021]
点击复制

名中医赵钢基于“卫气营血”论治下肢动脉硬化闭塞症经验

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
46
期数:
2025年10期
页码:
1404-1408
栏目:
名中医经验
出版日期:
2025-10-05

文章信息/Info

Title:
Famous doctor ZHAO Gang’s approach to treating lower extremity arteriosclerosis obliterans based on the wei-qi,ying-qi,and blood theory
作者:
吕勃川1; 张百亮1; 张美君1; 王茜1; 马丽媛2; 钟雅楠2; 张有志2
（1.黑龙江中医药大学附属第一医院，黑龙江 哈尔滨 150040；2.黑龙江中医药大学第一临床医学院，黑龙江 哈尔滨 150040）
Author(s):
LYU Bochuan1; ZHANG Bailiang1; ZHANG Meijun1; WANG Qian1; MA Liyuan2; ZHONG Yanan2; ZHANG Youzhi2
(1.The First Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150040,China；2.The First Clinical Medical College of Heilongjiang University of Chinese Medicine,Harbin 150040,China)
关键词:
下肢动脉硬化闭塞症; 卫气营血; 疏通营卫; 活血通脉; 荡涤浊瘀
Keywords:
Lower extremity arteriosclerosis obliterans; The theory of wei qi and ying xue; Nutrient and defense; Activating blood circulation and blocking meridians; Eliminating turbid stasis
分类号:
R 543.5
DOI:
DOI:10.3969/j.issn.1000-7369.2025.10.021
文献标志码:
A
摘要:
脉腑为下肢动脉硬化闭塞症病变部位，而卫气、营气与其关系十分密切。营卫同出一源，由水谷精微所化，营行脉中，卫行脉外，卫气、营气、脉腑三者相辅相成，三者中一者病变，则其余皆可发病。赵钢教授基于卫气营血理论治疗下肢动脉硬化闭塞症，认为该病的可分为四期。首先，年老体衰，饮食不节，劳逸失度为主要病因，该期病机特点为脾肾亏损，卫积脉中，内伐脉腑；其次卫损气衰，此期病机特点为气虚血迟；再次营卫两伤，此期病机特点为营血瘀滞脉腑；最后瘀血日久，化热伤津，瘀血干结而成干血劳，筋骨脉肌皮皆失所养，破溃失荣，此期病机特点为虚实夹杂、阴阳气血俱损。营卫气血、脉道贯穿于疾病的各个阶段，因此治疗上以疏通营卫为主，活血通脉为辅，以重建中州之气为本，荡涤浊瘀为标，通过畅卫、调营、通脉等方法，最终达到血脉畅行，营卫和谐的目的。
Abstract:
The pathology of lower extremity arteriosclerosis obliterans (LEASO) primarily manifests in the Maifu (meridian system),which is closely related to the dynamic interplay between wei-qi (Defensive qi) and ying-qi (Nutritive qi).Both wei-qi and ying-qi originate from the same source-he essence derived from food and water-with ying-qi circulating within the meridians and wei-qi flowing outside them.The interplay among wei-qi,ying-qi,and the Maifu is complementary and interdependent;dysfunction in any one of these components can lead to pathological changes in the others.Professor ZHAO Gang applies the wei-qi ying-blood theory to the treatment of LELEASO,categorizing the disease progression into four stages:Initial Stage (Etiology):Primarily caused by aging,physical decline,dietary irregularities,and improper balance of work and rest.The pathological mechanism here involves deficiency of the spleen and kidney,accumulation of wei-qi within the meridians,and internal damage to the Maifu.Wei-qi deficiency and qi impairment stage:characterized by qi deficiency and blood stagnation,where weakened wei-qi fails to protect and circulate,leading to sluggish blood flow.Dual damage to ying-qi and wei-qi stage:marked by stagnation of ying-blood in the meridians,where impaired ying-qi circulation exacerbates blood stasis within the Maifu.Advanced stage (chronic blood stasis):prolonged blood stasis transforms into heat,depletes body fluids,and leads to dry blood exhaustion (Ganxuelao).This stage results in malnutrition of tendons,bones,muscles,skin,and meridians,manifesting as non-healing ulcers.The pathology here reflects a complex interweaving of deficiency and excess,with comprehensive depletion of yin,yang,qi,and blood.Throughout all stages,the harmony of ying-qi,wei-qi,blood,and meridians is critical.Thus,treatment focuses on restoring the free flow of ying-qi and wei-qi as the primary strategy,supplemented by activating blood circulation and unblocking meridians.The therapeutic principles emphasize rebuilding the qi of the Middle Jiao (spleen and stomach)as the foundation while eliminating turbid stasis as the acute intervention.Methods such as regulating wei-qi,harmonizing ying-qi,and dredging meridians are employed to achieve the ultimate goal of unobstructed blood circulation and harmonious balance between ying and wei.

参考文献/References:

[1]陈孝平,汪建平.外科学[M].北京：人民卫生出版社，2024：488.
[2]中华医学会外科学分会血管外科学组.下肢动脉硬化闭塞症诊治指南[J].中华普通外科学文献(电子版),2016,10(1):1-18.
[3]PATEL M R,CONTE M S,CUTLIP D E,et al.Evaluation and treatment of patients with lower extremity peripheral artery disease:Consensus definitions from Peripheral Academic Research Consortium(PARC)[J].J Am Coll Cardiol,2015,65(9):931-941.
[4]ZHANG R,LAI Z C,LIU C W.Femoral-popliteal arteriosclerosis obliterans:Review of evidence-based studies on drug-eluting endovascular treatment[J].Zhongguo Yi Xue Ke Xue Yuan Xue Bao,2019,41(2):256-260.
[5]付佳娜,贾林龙,陈阚鹰,等.郑学军教授基于脉络学说治疗下肢动脉硬化闭塞症经验总结[J].广西中医药,2023,46(4):53-56.
[6]鲁达,李玉姣,何玉琼,等.当归四逆汤合阳和汤治疗动脉硬化闭塞症的疗效分析[J].中国民族医药杂志,2025,31(3):15-17.
[7]刘莺,吴玉泉,李志刚,等.顾步汤治疗下肢动脉硬化性闭塞症合并溃疡80例临床观察[J].血管与腔内血管外科杂志,2024,10(12):1524-1528.
[8]雷天浩,闫英.下肢动脉硬化性闭塞症的五期衍化及辨治[J].中医学报,2024,39(7):1422-1427.
[9]ZHANG Y,LYU B,TENG Y,et al.Systematic review and meta-analysis of Jueyin disease theory in the treatment of gangrene with traditional Chinese medicine formulations[J].Systematic Reviews,2025,14(1):95-98.
[10]端建刚.卫气营血辨证所含气化规律阐微[J].浙江中医杂志,2023,58(11):852-853.
[11]王冰.黄帝内经素问注[M].北京：人民卫生出版社，1963：74.
[12]张仲景.伤寒论[M].北京：人民卫生出版社，2005：7.
[13]李中梓.脾胃论[M].北京：人民卫生出版社，2005：16.
[14]李孟娜,朱明钱,陈鑫,等.升阳益胃汤对慢性胃炎小鼠胃组织病理变化及p38、ERK蛋白表达的影响[J].中国中医药科技,2024,31(2):200-202.
[15]张建平,王文,屈阳柳,等.补阳还五汤通过调控miR-210减轻大鼠脑缺血再灌注损伤的实验研究[J].陕西中医,2024,45(9):1176-1180.
[16]范增光,袁野.补阳还五汤对动脉粥样硬化模型小鼠SIRT1/HMGB1/NF-κB通路及炎症反应的影响[J].中西医结合心脑血管病杂志,2024,22(22):4109-4113.
[17]汤露环,吴梦茹,陈妍妍,等.羌活抗类风湿性关节炎活性成分及作用机制的研究进展[J].中草药,2024,55(9):3137-3145.
[18]朱静,梁健球,刘宝骅.川芎嗪调控Wnt/β-连环蛋白信号通路对冠心病大鼠心肌细胞凋亡的机制研究[J].陕西医学杂志,2024,53(1):13-18.
[19]陈露萍,杨轶童,赵苗苗,等.川芎嗪通过激活SIRT1信号通路减轻内皮细胞炎症损伤的机制研究[J].中国当代儿科杂志,2024,26(9):967-973.
[20]甘大文.当归四逆汤中药熏蒸治疗糖尿病周围神经病变40例临床观察[J].保健医学研究与实践,2014,11(4):42-44.
[21]付慧婕,雷根平,董盛,等.黄芪的现代药理作用及研究进展[J].河北中医,2025,47(4):695-699,704.
[22]张匣,邵欣欣,刘青芝,等.泽泻-白术药对及其活性成分防治动脉粥样硬化研究进展[J].中草药,2024,55(16):5735-5746.
[23]吕勃川,董延龙,葛明,等.大黄虫丸联合血府逐瘀汤加减防治下肢动脉硬化闭塞症介入术后再狭窄的临床研究[J].中医药信息,2021,38(10):58-62.
[24]李艳杰,李闪宜,高琪,等.大黄虫丸的临床应用与药理作用研究进展[J].世界中医药,2024,19(23):3644-3649.
[25]陈凡平,宁红霞,汪海波,等.大黄虫丸联合西药治疗下肢动脉硬化闭塞症疗效研究[J].陕西中医,2025,46(3):364-367.
[26]赵钢，李令根，吕勃川，等.周围血管病基础与临床[M].北京：人民军医出版社，2015：213-214.

相似文献/References:

[1]陈凡平,宁红霞,汪海波,等.大黄虫丸联合西药治疗下肢动脉硬化闭塞症疗效研究[J].陕西中医,2025,46(3):364.[doi:DOI:10.3969/j.issn.1000-7369.2025.03.016]
　CHEN Fanping,NING Hongxia,WANG Haibo,et al.Study on application of Dahuang Zhechong pill combined with conventional western medicine in treatment of arteriosclerosis obliterans of lower limbs[J].,2025,46(10):364.[doi:DOI:10.3969/j.issn.1000-7369.2025.03.016]

备注/Memo

备注/Memo:
黑龙江省中医药科研项目(ZYW2024-115)
更新日期/Last Update: 2025-10-10