基于"营卫倾移"理论探讨免疫代谢紊乱在下肢动脉粥样硬化中的病机及辨治OA

Lower extremity artery disease(LEAD)is a chronic inflammatory disease characterized by atherosclerotic lesions affecting the medium and large arteries of the lower limbs.Its main clinical manifestations include numbness,cold sensation,pain,and intermittent claudication of the lower extremities;severe cases may progress to ulceration or even gangrene.The disease has a high incidence rate and tends to be protracted and difficult to cure.Based on the TCM theory of"tipping and shifting of Ying-nutrients and Wei-defence"and considering immune-metabolic dysregulation as a key pathological link,this paper proposes that the pathogenesis of LEAD evolves from the initial stage where external and internal pathogenic factors combine to cause"tipping of Ying-nutrients and Wei-defence",progresses to"shifting of Ying-nutrients and Wei-defence"with generation of phlegm and blood stasis internally,and finally leads to toxin obstructing the Ying-nutrients and Wei-defence,resulting in dysfunction of the spirit.In terms of treatment,harmonizing Ying-nutrients and Wei-defence is regarded as the general principle.At the initial stage,the priority is to tonify and harmonize Ying-nutrients and Wei-defence,dispel pathogenic factors,and prevent bi-impediment,using modified Guizhi Decoction.At the progressive stage,the focus is on resolving phlegm and removing blood stasis and reconnecting Ying-nutrients and Wei-defence,using modified Chiqilin Powder.At the advanced stage,the treatment aims to unblock the collaterals,regulate the spirit,and unblock Ying-nutrients and Wei-defence,using modified Shaoyao Gancao Decoction combined with Simiao Yong'an Decoction.This paper aims to enrich the TCM theory of"Ying-nutrients and Wei-defence"and to provide theoretical support for the clinical application of Chinese medicine in the prevention and treatment of LEAD.