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中国防痨杂志 ›› 2026, Vol. 48 ›› Issue (7): 1021-1029.doi: 10.19982/j.issn.1000-6621.20260094

• 论著 • 上一篇    下一篇

散结贴外治破溃期淋巴结结核的态靶辨治思路

高娴1, 尚希钰1, 刘甜甜1, 杨洁1, 李子煕2, 孙燕歌1, 韦锦生1, 成诗明3, 马艳4, 李洪智1()   

  1. 1 郑州市第六人民医院结核科, 郑州 450000
    2 吉林大学白求恩第一临床医学院, 长春 130021
    3 中国防痨协会, 北京 100710
    4 中国中医科学院中医临床基础医学研究所, 北京 100700
  • 收稿日期:2026-02-15 出版日期:2026-07-10 发布日期:2026-07-02
  • 通信作者: 李洪智,Email:851805963@qq.com
  • 基金资助:
    郑州市科技局创新指导项目(2025YLZDJH100);郑州市科技局创新指导项目(2025YLZDJH103);河南省中医药科学研究专项课题(2024ZY2171)

State-Target differentiation and treatment strategy for ulcerative lymph node tuberculosis with external application of Sanjie Plaster

Gao Xian1, Shang Xiyu1, Liu Tiantian1, Yang Jie1, Li Zixi2, Sun Yange1, Wei Jinsheng1, Cheng Shiming3, Ma Yan4, Li Hongzhi1()   

  1. 1 Department of Tuberculosis, Zhengzhou Sixth People’s Hospital, Zhengzhou 450000, China
    2 The First Norman Bethune Hospital, Jilin University, Changchun 130021, China
    3 Chinese Antituberculosis Association, Beijing 100710, China
    4 Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China
  • Received:2026-02-15 Online:2026-07-10 Published:2026-07-02
  • Contact: Li Hongzhi, Email: 851805963@qq.com
  • Supported by:
    Innovation Guidance Project of Zhengzhou Science and Technology Bureau(2025YLZDJH100);Innovation Guidance Project of Zhengzhou Science and Technology Bureau(2025YLZDJH103);Special Project for Scientific Research on Traditional Chinese Medicine of Henan Province(2024ZY2171)

摘要:

本文基于仝小林院士提出的“态靶”理论,系统阐释淋巴结结核的动态演变规律,构建“三期四态”辨治框架,并在此框架下深入分析临床验方散结贴外治破溃期淋巴结结核的“调态”与“打靶”作用机制。淋巴结结核的疾病过程遵循“郁(气滞痰凝,早期)→瘀(痰瘀互结,早期)→火(阴虚火旺,中期)→虚(气血两虚,晚期)”的动态演化路径。散结贴针对破溃期“瘀热留滞、气血两虚”的核心病机,以黄芪益气养血、托毒生肌,丹参、天花粉、乳香、没药等清热化瘀以“调态”;同时通过多成分、多途径促进创面愈合、缓解疼痛、调节异常细胞因子水平、增强免疫功能以“打靶”,实现态靶协同、内外兼治。“态靶”理论为淋巴结结核的中医精准辨治提供了创新性理论框架,散结贴外治法在该理论指导下体现出明确的临床疗效与推广价值。

关键词: 结核, 淋巴结, 医学, 中国传统, 散结贴

Abstract:

Based on the “State-Target” theory proposed by Academician Tong Xiaolin, this study systematically elucidates the dynamic evolution of lymph node tuberculosis, establishes a “three-stage and four-state” syndrome differentiation framework. Within this framework, deeply analyzes the “state-regulating” and “target-hitting” mechanisms of the clinical empirical formula Sanjie Tie (Dispersion Plaster) in the external treatment of lymph node tuberculosis during the ulcerative stage. The disease course of lymph node tuberculosis follows a dynamic pathological evolution pathway of “stagnation (qi stagnation and phlegm coagulation, early stage)→stasis (phlegm and blood stasis, early stage)→fire (yin deficiency and fire effulgence, middle stage)→deficiency (qi and blood deficiency, late stage)”. For the core pathogenesis of “lingering heat stasis with qi-blood deficiency” in the ulcerative stage, Sanjie Plaster uses Huangqi (Astragali Radix) to tonify qi and nourish blood, eliminate toxins and promote tissue regeneration; and employs Danshen (Salviae Miltiorrhizae Radix), Tianhuafen (Trichosanthis Radix), Ruxiang (Olibanum) and Moyao (Myrrha) to clear heat and resolve stasis for state regulation. Meanwhile, it achieves target-striking effects through multi-components and multi-pathways, including promoting wound healing, alleviating pain, regulating abnormal cytokine levels and enhancing immune function, thus realizing the synergy of state and target as well as the combination of internal and external treatment. The “State-Target” theory provides an innovative theoretical framework for the precise differentiation and treatment of lymph node tuberculosis in traditional Chinese medicine, and the external treatment with Sanjie Tie demonstrates clear clinical efficacy and promotional value under the guidance of the theory.

Key words: Tuberculosis, lymph node, Medicine, Chinese traditional, Sanjie plaster

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