孙络作为经络系统的最远端分支，从形态学角度来说，与西医的微小血管相仿，过敏性紫癜则是全身性血管炎症的 一种表现。《黄帝内经》中关于孙络“溢奇邪、通营卫”的论述，对中医治疗过敏性紫癜提供了宝贵的理论指导。该文深入 剖析孙络的生理作用，提出过敏性紫癜的形成，乃因奇邪侵袭孙络，营卫失调，热瘀阻脉，血溢脉外，引发皮肤紫斑、消 化道出血、关节疼痛不适等症状。这些症状进一步干扰营卫的交汇与生化，导致津液和血液失衡，津液外溢孙络，无法回 流，造成水液停滞。瘀血与水湿在肾络中凝聚，可能引发肾脏损伤，出现血尿和蛋白尿。疾病的不同阶段病机可概括为早 期奇邪侵犯孙络，卫滞阻营；中期火毒燔灼孙络，波及营卫，阳损及阴；或湿邪通过孙络犯下，侵犯阴脏；后期正虚络瘀， 肾失封藏。针对这些病理机制，治疗原则应以“调治风血，畅通孙络”为核心，以减轻紫癜症状，缩短病程，促进康复， 实现整体的防治效果。

As the most distal branches of the meridian system，tertiary collaterals （sunluo） are morphologically similar to microvessels in western medicine， while Henoch-Schönlein purpura （HSP） is a manifestation of systemic vascular inflammation. The discussion in Huang Di Nei Jing（The Yellow Emperor’s Inner Classic） regarding tertiary collaterals “draining pathogenic factors and regulating ying-wei” provides valuable theoretical guidance for the traditional Chinese medicine （TCM） treatment of HSP. This article thoroughly analyzes the physiological functions of tertiary collaterals and proposes that the formation of HSP is due to the invasion of pathogenic factors into the tertiary collaterals，leading to the imbalance of ying-wei，heat stasis obstructing the vessels，and blood extravasation，resulting in symptoms such as skin purpura，gastrointestinal bleeding，and joint pain. These symptoms further interfere with the convergence and biochemical processes of ying-wei，causing an imbalance of body fluids and blood. The overflow of body fluids from the tertiary collaterals，unable to return， leads to fluid stagnation. The accumulation of blood stasis and dampness in the kidney collaterals may cause kidney damage， manifesting as hematuria and proteinuria. The pathogenesis at different stages of the disease can be summarized as follows： in the early stage， pathogenic factors invade the tertiary collaterals， causing wei stagnation and ying obstruction；in the middle stage，fire toxin scorches the tertiary collaterals，affecting yingwei， damaging yang and yin； or damp pathogens invade the lower regions through the tertiary collaterals， affecting the yin organs；in the late stage，deficiency of vital qi and collateral stasis lead to kidney dysfunction. Based on these pathological mechanisms，the treatment principle should focus on “harmonizing pathogenic wind and blood circulation，and unblocking the tertiary collaterals，” aiming to alleviate purpura symptoms，shorten the disease course，promote recovery，and achieve comprehensive prevention and treatment effects.

R246.9

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