基于"营卫-脉络"探讨动脉硬化闭塞症早期病机及治法OA

Lower extremity atherosclerotic occlusive disease(ASO)is an ischemic disorder of the lower limbs primarily caused by atherosclerosis.This condition has an initially insidious onset,with mild initial symptoms that are often overlooked,leading to delayed diagnosis and treatment.The disease course is typically prolonged and prone to recurrence,significantly impairing patients'quality of life.Current Western medical treatments are either limited in scope or associated with high recurrence rates.This article systematically summarizes the understanding of the pathogenesis and therapeutic experience of Professor ZHENG Xuejun—a renowned traditional Chinese medicine practitioner in Shanxi Province—regarding early-stage ASO,based on the"Ying Wei(营卫)and collateral"theory articulated in the Huangdi Neijing(《黄帝内经》)and the Nanjing(《难经》).Drawing upon decades of clinical practice,Professor ZHENG proposes that the core pathogenic mechanism in early-stage ASO is dysfunction of Sanjiao(三焦)transportation and transformation,resulting in stagnation of Ying and Wei Qi(气),followed by mutual accumulation of phlegm and blood stasis that ultimately damages the structural integrity of the collaterals.Sanjiao serves as the channel through which Ying-Qi and Wei-Qi circulate.When the transportation and transformation function of the triple burner becomes impaired,the generation,distribution,and perfusion of Ying-Qi and Wei-Qi are all adversely affected,clinically manifesting as intermittent claudication,numbness at the extremities,muscle atrophy,and coldness in the lower limbs.Over time,the coordinated circulation of Ying-Qi and Wei-Qi becomes disordered,leading to the conglomeration of phlegm and blood stasis on the collateral walls and ultimately resulting in structural damage to the collaterals.Therapeutically,restoring the transportation and transformation function of the triple burner is paramount,achieved through an integrated strategy combining warming Yang(阳)to nourish the collaterals,strengthening the spleen to enrich the collaterals,and regulating Qi to activate blood circulation.Rather than adhering rigidly to the conventional approach of"treating blood stasis when blood stasis is observed,"Professor ZHENG addresses early-stage ASO by targeting the triple burner:tonifying Ying Zong(宗)-Qi from above,fortifying the spleen and stomach centrally,and warming kidney-Yang from below—thereby enabling spontaneous harmonization of Ying-Qi and Wei-Qi and natural resolution of stasis and turbidity.His proprietary Arterial Formula No.Ⅱ(创动脉Ⅱ号方)comprises Huangqi(Astragali Radix)and Dangshen(Angelicae Sinensis Radix)to replenish the middle Jiao and support the source of Ying-Qi and Wei-Qi production.Taoren(Persicae Semen)and Honghua(Carthami Flos)to unblock the triple burner and facilitate smooth circulation of Ying-Qi and Wei-Qi.Sanleng(Sparganii Rhizoma)and Ezhu(Curcumae Rhizoma)to resolve stagnation and remove obstacles impeding Ying-Qi and Wei-Qi flow,Thereby harmonizing Ying-Qi and Wei-Qi.Collectively,these herbs restore normal transportation and transformation function of the triple burner and reestablish orderly coordination between Ying-Qi and Wei-Qi.This article elucidates Professor ZHENG Xuejun's understanding of the pathogenesis and therapeutic experience in early-stage ASO from the perspective of"nutritive Qi and defensive Qi collateral network",aiming to provide novel theoretical foundations and clinical insights for early intervention in this condition.