张燚 “分期-身心同治”银屑病  

ZHANG Yi Psychosomatic Treatment by Stages on Psoriasis

作　　者：王珂 张燚[2] WANG Kea;ZHANG Yib(Liaoning University of Traditional Chinese Medicine：a.2015 Graduate School of Chinese Medicine,First Clinical College,Department of Dermatology,b.Second Affiliated Hospital,Shenyang 110032,China)

机构地区：[1]辽宁中医药大学第一临床学院,沈阳110032 [2]辽宁中医药大学附属二院皮肤科,沈阳110032

出　　处：《实用中医内科杂志》2018年第3期6-9,共4页Journal of Practical Traditional Chinese Internal Medicine

摘　　要：张燚教授认为"形神合一""整体观""情志与五脏相关"等都蕴含丰富的心身医学理论和思想,银屑病乃内有郁热,外感风寒、风热,阻于肌肤,蕴结不散;或性情急躁,火从心生,或外邪侵袭致邪毒内蕴,或嗜食辛发膏粱厚味之品,脾胃积热郁滞日久,发于肌肤,热极风动发为红斑,高突皮肤;或素体虚弱久病体虚,因营血不足,阴虚化燥生风,肌肤失养而发为红疹略带鳞屑;或病程日久,气血运行不畅,经脉阻塞,气血瘀结使肌肤失于滋养;或热蕴日久,化燥生风,或流窜关节,闭阻经络,或热毒炽盛,气血营阴两燔而发;亦与情志因素密切相关,提出滋阴清热、润燥息风、活血化瘀、解毒除湿,配伍疏肝解郁,行气化滞药物,"疗形勿忘治神,调神勿忘治形",结合心理疏导,身心同治;强调观察患者心理情志与生理、生化变化相关性,可更好地达到身心同治的目的。临床分期辨治:早期进行期,多火热内盛,重在滋阴凉血疏肝清热,调畅气机,润肤消斑;中期迁延期,多血虚风燥,滋阴养肝,健脾养血,润燥息风;晚期退行期,多配合饮食调护,养脾健脾,疏肝理气,调畅情志。外加外用软膏、油剂达安抚退疹、润肤止痒的功用。常用ZUNG抑郁自评量表(SDS)和ZUNG焦虑量表(SAS)评定抑郁和焦虑情感。附寻常型银屑病(白疕-血热内蕴)验案1则。Professor ZHANG Yi holds that ＂the unity of form and spirit＂, ＂holistic view＂ and ＂emotion and the relationship between the five internal organs＂ all contain a wealth of psychosomatic medical theories and thoughts. Psoriasis is characterized by depression, exogenous cold, wind and heat, implying that the end is not scattered; or impatient temperament, fire from the heart, or the invasion of evil caused by evil venom intrinsic, or addicted to greasy and surfeit flavour, gastrointestinal accumulated heat for a long time, stasis in the skin, heat edema is erythema, hyperextension skin; or physical weakness chronic illness deficiency, due to lack of blood circulation, impede circulation of Qi and blood, skin dystrophy and rash slightly scaly; or the course of time, blood being insufficient, meridians blocked, Qi and blood stasis to make the skin nourish the skin; skin is lost to nourishment, or flow through the joints, blocking the meridians, or hot flaming flashes, blood Ying Yin burnt; also with emotional factors are closely related, proposed nourishing Yin and clearing heat, moistening the wind, promoting blood circulation, detoxification dehumidification, compatibility dispersing stagnated liver Qi for relieving Qi stagnation, Qi stagnation of drugs, combined with psychological counseling, psychosomatic treatment; emphasis on observation of patients with emotional and physiological, biochemical changes related can better achieve the purpose of psychosomatic treatment. Clinical stage of differentiation： early stage, more hot inside, focusing on nourishing Yin and blood Shugan heat, transfer of Qi machine, soothing Xiaoban; mid-term delay, more blood deficiency wind dry, nourishing liver, spleen nourishing, moistening the wind; advanced degenerative phase, with more diet adjustment, spleen and spleen, liver and qi, smooth emotions. External topical ointment, oil up to appease the rash, soothing itch function. Depression and anxiety were assessed by using the Zung Self-rating Depression Scale （SDS）

关 键 词：银屑病 白疕 身心同治 心身医学 形神合一 整体观 分期 滋阴清热 活血化瘀 ZUNG抑郁自评量表(SDS) ZUNG焦虑量表(SAS) 中药复方 张燚 老中医经验 中医药治疗 

分 类 号：R249[医药卫生—中医临床基础] R275.9[医药卫生—中医学]