Exploration of tonifying yang principle and the “bolt-plank-hinge mechanism of the three yang” in the differentiated treatment of Henoch-SchöNlein purpura

Henoch-Schönlein purpura (HSP) is a clinically common vascular allergic disease, primarily manifested as skin bleeding spots or ecchymosis, which may be accompanied by joint symptoms, gastrointestinal symptoms, renal injury, etc. HSP falls under the category of "blood syndromes" (xue zheng) according to traditional Chinese medical (TCM) and corresponds to classical patterns such as Zidian Feng (purpuric rash wind), Ji′nyu (muscular hemorrhage), Xueyi (blood effusion), and Xuehan (bloody sweat). Under syndrome differentiation and treatment, TCM has significant advantages in improving symptoms of HSP patients, reducing recurrence rates, and alleviating side effects from hormone therapy during treatment. Guided by tonifying yang thought and incorporating the "bolt-plank hinge mechanism of the three yang" theory from the Huangdi Neijing, this study systematically examines the roles of the solitary yang in the kidney and the three yang meridians (Taiyang, Shaoyang, and Yangming) in the onset and progression of HSP. By analyzing the function of kidney yang and elucidating the concept of Taiyang as the "bolt" (kai), Yangming as the "plank" (he), and Shaoyang as the "hinge" (shu), the article applies the following treatment principles: warming and reinforcing kidney yang to promote circulation, warming the middle jiao to tonify deficiency, and warming and regulating the San Jiao. The goal is to supplement the kidney yang and regulate the functions of the three yang, ultimately lead to resolution of the purpura and achieve coordinated improvement of both local clinical symptoms and overall manifestations. This approach not only provides new theoretical support for the TCM-based treatment of HSP and further expands the application of tonifying yang thought and the "bolt-plank hinge mechanism of the three yang" theory to different disease areas, but also helps to leverage the advantages of individualized, syndrome differentiation based treatment in TCM.