| 引用本文: |
韩驰, 周佳, 赵用.从“漏泄”理论探讨干燥综合征的病机与辨治[J].湖南中医药大学学报,2026,46(5):1011-1016[点击复制] |
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| 从“漏泄”理论探讨干燥综合征的病机与辨治 |
| 韩驰,周佳,赵用 |
| (辽宁中医药大学第二临床学院, 辽宁 沈阳 110847;辽宁中医药大学附属第二医院, 辽宁 沈阳 110034) |
| 摘要: |
| 本文以“漏泄”理论为核心，创新性提出卫气失固、腠理开阖失常所致津液异常外泄为干燥综合征（SS）的始动病机；其核心病机为津液妄泄、阴精亏虚、诸窍失濡，病理演变循“卫虚-津伤-精亏”三阶段递进：卫气微泄、风燥客表为发病之基，气阴两虚、漏泄益甚为病进之由，精亏瘀阻、漏泄难复为痼疾之根。据此以固卫止泄、通补结合为核心治则，分阶段施治：初期施以固卫润燥、轻宣达邪之法，方选玉屏风散合沙参麦冬汤加减；中期施以益气敛津、清热润燥之法，方选生脉散合益胃汤加减；后期施以滋阴填精、通补化瘀之法，方选左归丸合桃红四物汤加减。临证以补通兼施、以通为用，为SS的中医药辨治提供新视角与借鉴。 |
| 关键词: 干燥综合征|漏泄|卫气失固|津液不藏|精亏瘀阻 |
| DOI：10.3969/j.issn.1674-070X.2026.05.020 |
| 投稿时间：2025-11-25 |
| 基金项目:辽宁省名中医传承工作室（辽中医药综合字〔2024〕19号）；沈阳市科学技术计划公共卫生研发专项（24-214-3-180）。 |
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| Pathogenesis and pattern identification-based treatment of Sjögren's syndrome from the "leakage" theory |
| HAN Chi, ZHOU Jia, ZHAO Yong |
| (Second Clinical College, Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning 110847, China;The Second Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning 110034, China) |
| Abstract: |
| Grounded in the "leakage" theory, this study innovatively proposes that the initiating pathogenesis of Sjögren's syndrome (SS) is the abnormal external leakage of body fluids caused by Wei-defensive qi failing to secure the surface and dysregulation of the interstices in opening and closing. The core pathogenesis consists of chaotic leakage of body fluids, deficiency of yin essence, and loss of moistening of the orifices. The pathological evolution follows three progressive stages: "Wei-defensive qi deficiency→fluid injury→essence depletion." Specifically, slight leakage of Wei-defensive qi with wind-dryness lodging in the exterior is the foundation of disease onset; dual deficiency of qi and yin with aggravated leakage is the cause of disease progression; and essence depletion with stasis obstruction and difficult-to-heal leakage is the root of chronic, refractory disease. Based on this, the core treatment principles are consolidating Wei-defensive qi to stop leakage, combined with both unblocking and tonifying methods, applied in a stage-dependent manner. In the initial stage, methods of consolidating Wei-defensive qi, moistening dryness, and gently dispersing to expel pathogens are adopted, with modified Yupingfeng Powder combined with Shashen Maidong Decoction. In the middle stage, methods of supplementing qi, astringing fluids, clearing heat, and moistening dryness are used, with modified Shengmai Powder combined with Yiwei Decoction. In the late stage, methods of nourishing yin, replenishing essence, unblocking and tonifying, and transforming stasis are applied, with modified Zuogui Pill combined with Taohong Siwu Decoction. In clinical practice, emphasis should be placed on the simultaneous application of tonification and unblocking, with unblocking as a key approach. This study provides a new perspective and reference for the pattern identification-based treatment of SS with Chinese medicine. |
| Key words: leakage|Sjögren's syndrome|failure of body fluids to be stored|theoretical discussion |
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