1.1.4 Other Factors

1.1.4 Other Factors

Long-term untreated anemia, chronic renal failure, anterior pituitary and thyroid hypofunction, immune factors, genetic factors can all cause aplasia. Some cases of paroxysmal nocturnal hemoglobinuria (PNH) can also develop into aplasia, known as "AA-PNH syndrome."

Regarding the causative factors of aplasia, TCM believes that the main reasons are insufficient innate endowment, the Six Evils, the Seven Emotions, dietary indiscretion, overwork, sexual indulgence, and other factors that harm qi and blood and the zang-fu organs, particularly affecting the heart, liver, spleen, and kidneys, thus leading to blood deficiency and deficiency fatigue syndromes.

Insufficient Innate Endowment: "Children's fatigue originates from the mother's womb," records "Supplement to the Clear Guide of Famous Doctors." He Sizong's "Transmission of Heart Knowledge on Deficiency Fatigue" states: "When children suffer from this condition, it is due to insufficient innate endowment, especially when inherited from the mother's qi, so it is generally called 'children's fatigue.'" This may include some congenital pediatric aplasia cases.

Six Evils: Excessive or untimely exposure to wind, cold, heat, dampness, dryness, and fire can all trigger this disease. Wind and cold can directly invade the Three Yin, affecting the kidneys, spleen, and liver.

Seven Emotions Gone Wild: Overwork harms the kidneys, excessive thinking harms the spleen, and extreme anger harms the liver—these are important causes of deficiency damage. Deficiency in the kidneys, spleen, and liver can lead to dysfunction of the five zang and six fu organs. "The Yellow Emperor's Inner Canon" records: "When vital energy is depleted internally, accumulation of deficiency leads to damage, and accumulation of damage leads to fatigue." "Classified Treatment Guidelines" records: "All deficiency damage originates from the spleen and stomach, while fatigue mostly originates from the kidney meridian," which also shows that this kind of deficiency disease is caused by internal depletion of vital energy and is related to the spleen and kidneys.

Qi and blood are important components of the body's righteous qi. Patients with aplasia, due to dual deficiency of qi and blood and internal depletion of vital energy, are prone to infection. Qi deficiency cannot control blood, yin deficiency causes internal heat, and external fevers, heat injuring blood vessels, or forcing blood to flow abnormally, can all cause bleeding. This is the mechanism behind the three main symptoms of aplasia: blood deficiency, bleeding, and fever.