摘要
原发性血小板增多症是一种以血栓形成和出血为临床特征的骨髓增殖性肿瘤,起病隐匿,疾病进展缓慢,大多数患者长期无明显临床症状,多因血小板增多、脾大或血栓时间被确诊。西医治疗多以羟基脲为首选药物,但长期使用羟基脲容易出现骨髓抑制、胃肠道反应及皮肤血管毒性等不良反应。而中药副作用小,成本低,患者耐受性好,在原发性血小板增多症的临床治疗上效果显著。罗秀素教授系第六批全国老中医药专家学术经验继承工作室指导老师,从事血液系统疾病临床诊治50余载,在中医治疗原发性血小板增多症方面积累了丰富的临床经验。在长期实践过程中,罗教授发现大多数患者存在肝肾亏虚的证候,基于气血津液及脏腑辨证,结合原发性血小板增多症的临床特点,罗教授认为原发性血小板增多症的发病病机以“肝肾亏虚”为本,以“郁火、瘀血、痰湿”为标,多为虚实夹杂证,提出从肝肾论治的重要性,强调在活血化瘀的同时滋补肝肾,在治疗上兼顾虚实,肝肾同治,临床应用中辨证施治,组方遣药有的放矢,疗效显著。
Essential thrombocythemia is a myeloproliferative neoplasm characterized by clinical features of thrombosis and bleeding,with an insidious onset and gradual disease progression.Most patients remain asymptomatic for extended periods before being diagnosed with thrombocythemia,splenomegaly,or thrombotic events.Conventional Western treatment typically employs hydroxyurea as the primary therapeutic agent;however,prolonged use of hydroxyurea may lead to hematopoietic suppression,gastrointestinal disturbances,and cutaneous vascular toxicity among other adverse effects.In contrast,traditional Chinese medicine offers fewer side effects,lower costs,and improved patient tolerance while demonstrating significant efficacy in managing essential thrombocythemia.Professor LUO Xiusu serves as an instructor at the sixth batch of National Master Studio for Traditional Chinese Medicine Experience Inheritance;she has dedicated over 50 years to diagnosing and treating hematologic disorders clinically.In the long-term clinical practice,Professor LUO has found that most patients have the syndrome of deficiency of liver and kidney.Based on the syndrome differentiation of qi,blood,body fluid and viscera,combined with the clinical characteristics of essential thrombocythemia,Professor LUO believes that the pathogenesis of essential thrombocythemia is based on"deficiency of liver and kidney",characterized by"depression and fire,blood stasis and phlegm dampness",and most of them are deficiency and excess syndrome.In the treatment,both deficiency and excess are taken into account,liver and kidney are treated simultaneously.In the clinical application,the treatment is based on syndrome differentiation,and the prescription and drug administration are targeted,and the curative effect is remarkable.
作者
陈凯丽
庄海峰
罗秀素
CHEN Kaili;ZHUANG Haifeng;LUO Xiusu(The First Clinical Medical College,Zhejiang Chinese Medical University,Zhejiang Province,Hangzhou 310053,China;Department of Clinical Blood Transfusion,the First Affiliated Hospital of Zhejiang Chinese Medical University,Zhejiang Province,Hangzhou 310018,China;Department of Hematology,the First Affiliated Hospital of Zhejiang Chinese Medical University,Zhejiang Province,Hangzhou 310018,China)
出处
《中国当代医药》
2025年第14期122-125,共4页
China Modern Medicine
关键词
原发性血小板增多症
肝肾同治
罗秀素
名医经验
Essential thrombocythemia
Simultaneous treatment of liver and kidney
LUO Xiusu
Famous doctor's experience
作者简介
陈凯丽(1998-),女,浙江中医药大学中医内科学专业2022级在读硕士研究生,研究方向:中医药防治血液病;通讯作者:庄海峰(1978-),男,浙江杭州人,博士,副主任医师,浙江省中医院临床输血科主任,研究方向:中西医结合防治血液病。
