Staged Treatment of Microvascular Lesions in Porto-Sinusoidal Vascular Disease Based on the Collaterals-Regulating Approach of Insect-Derived Medicinals

Xingrong LI; Haihang DONG; Yuying TU; Huiqin ZHANG; Ya YOU; Yinqiang ZHANG

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Staged Treatment of Microvascular Lesions in Porto-Sinusoidal Vascular Disease Based on the Collaterals-Regulating Approach of Insect-Derived Medicinals

VernacularTitle:运用虫类药分期治疗门静脉肝窦血管病微血管病变
Author: Xingrong LI ¹ ; Haihang DONG ¹ ; Yuying TU ¹ ; Huiqin ZHANG ¹ ; Ya YOU ¹ ; Yinqiang ZHANG ¹
Author Information

1. Xiyuan Hospital，China Academy of Chinese Medical Sciences，Beijing，100091
Publication Type:Journal Article
Keywords: porto-sinusoidal vascular disease; insect-derived medicinals; collateral disease; Chaihu Biejia Decoction （柴胡鳖甲汤）
From: Journal of Traditional Chinese Medicine 2026;67(17):1905-1909
CountryChina
Language:Chinese
Abstract: It is proposed that the core pathogenesis of porto-sinusoidal vascular disease （PSVD） is characterized by deficiency of healthy qi with collateral stagnation and the binding of stasis and toxin. According to the characteristics of its microvascular lesions， PSVD can be treated through syndrome differentiation in three stages， including the occult stage， progressive stage， and decompensated stage. Considering the properties of insect-derived medicinals， such as rapid movement， penetrating action， and ability to search out pathogen and unblock collaterals， three therapeutic principles are established， which are unblocking collaterals， softening the liver， and dispelling pathogen. Clinically， the New-Modified Chaihu Biejia Decoction （柴胡鳖甲汤） is used as the basic prescription with staged modifications. During the occult stage， medicinals such as Quanxie （Scorpio） and Wugong （Scolopendra） are added to search out pathogen， unblock collaterals， and protect the channels from progression. During the progressive stage， Tubiechong （Eupolyphaga seu Steleophaga） and Qianglang （Catharsius molossus） are added to dispel stasis and soften hard masses， thereby removing concretions and dissipating masses. During the decompensated stage， Shuizhi （Hirudo） and Dilong （Pheretima） are added to eliminate stasis and promote urination， treating blood and fluid retention simultaneously.