瘀血的生成始于虚劳所致气血乏源、运行失畅，虚损与瘀滞燥结生化干血，复因邪热蒸煽演化劳瘵，而形成“虚劳-干血-劳瘵”的传变路径。文章基于瘀血病理要素在原发性骨髓纤维化的生成、发展与演变过程中的主体地位，探讨原发性骨髓纤维化病机及辨证思路，认为疾病发生以虚劳内生为本，疾病成形以干血内结为常，疾病转化以劳瘵内化为变，对其治疗应兼顾扶正与祛邪两方面，纤维化前期根于固本清源，明显纤维化期治以缓中补虚，疾病进展转白重在养阴解毒。附验案1则。

The formation of blood stasis begins with the deficiency of qi and blood due to consumptive disease,which leads to the lack of source and poor circulation of qi and blood. Deficiency and weakness,as well as blood stasis and dryness,generate dry blood. Subsequently,due to the steam and dampness of pathogenic heat,it evolves into chronic infectious disease,thus forming a transmission and transformation path of “consumptive disease-dry blood-chronic infectious disease”. Based on the dominant position of the pathological elements of blood stasis in the generation,development and evolution of primary myelofibrosis,this article explores the pathogenesis and syndrome differentiation and treatment of primary myelofibrosis. It holds that the onset of the disease is based on internal deficiency and fatigue,the formation of the disease is often due to the internal formation of dry blood,and the transformation of the disease is due to internal consumption,which leads to chronic infectious disease. The treatment of this disease should take into account both strengthening the body's resistance and eliminating pathogenic factors. In the early stage of fibrosis,the basic treatment lies in strengthening the body and clearing the source. During the obvious fibrosis stage,the treatment should focus on gradual recovery and tonifying deficiency. When the disease progresses and turns into leukemia,the key is to nourish yin and detoxify. One test case is attached.