基于"态靶辨证"理论探析柳越冬辨治内痔思路OA

This paper explores the clinical experience of Professor Liu Yuedong in the differentiation and treatment of internal hemorrhoids based on the theory of"state-target syndrome differentiation".Professor Liu summarizes the core pathogenesis of internal hemorrhoids into four distinct pathological states:heat,stasis,deficiency,and dryness.Specifically,for the heat state,the treatment principle is to clear heat and eliminate dampness,cool the blood,and stop bleeding;for the stasis state,the principle is to activate blood,resolve stasis,promote qi flow,and unblock collaterals;for the deficiency state,the principle is to tonify the middle energizer and boost qi,lift yang and secure prolapse;and for the dryness state,the principle is to nourish yin and enrich blood,increase fluids and moisten the intestines.On the basis of macroscopic state modulation,specific target formulas and medicinals are established to precisely address core symptomatic targets such as hematochezia,anal bearing-down distension,and constipation,as well as objective clinical targets including positive fecal occult blood,decreased hemoglobin levels,and hemorrhoidal congestion and edema.Furthermore,from a modern pathological perspective,attention is directed toward potential microscopic targets,such as vascular endothelial growth factor(VEGF)and matrix metalloproteinase-9(MMP-9).This therapeutic strategy achieves an organic integration of conventional syndrome differentiation with precision medicine,thereby providing new insights into the modernized diagnosis and treatment of internal hemorrhoids with traditional Chinese medicine.