从脾论治脂溢性脱发  

Treating Seborrheic Alopecia from Spleen

作　　者：王一君 吴景东 WANG Yijun;WU Jingdong(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China;the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110034,Liaoning,China)

机构地区：[1]辽宁中医药大学,辽宁沈阳110847 [2]辽宁中医药大学附属第二医院,辽宁沈阳110034

出　　处：《实用中医内科杂志》2020年第3期65-68,共4页Journal of Practical Traditional Chinese Internal Medicine

基　　金：辽宁省科技厅自然基金项目(201602497)。

摘　　要：脂溢性脱发为皮肤科常见疾病,因其治疗困难又有碍美观,对患者的心理健康影响较大,并且发病率又在逐年升高。基于以上原因,阐述"从脾论治"脂溢性脱发的理论基础和治疗原则,根据目前对脂溢性脱发的研究进展,从中西医结合角度出发,进一步确定了疾病的分类及诊断标准,从病因病理病机等深层次掌握脂溢性脱发。西医认为脂溢性脱发主要病因为雄激素的代谢失常、DHT、2型5α-还原酶、和雄激素受体的水平关系密切,并与遗传、内分泌失调、情绪、自身免疫等因素均可相关;中医认为该病为本虚标实之证,本为脾肾亏虚,标为湿热内蕴、血热风燥、瘀阻毛窍等等;因人们生活习惯、饮食结构的改变,常常以酒为浆,以妄为常,逆于生乐,起居无节,长此以往会损伤脾胃,以导致脾虚、湿生,故此在诸多分型当中,脾虚湿盛型又占有较大的比例;在治疗脾肾亏虚导致的脂溢性脱发方面,应首先要健脾温阳以固本,再以化痰、除湿、祛脂、活血以去标;平素养脾护脾也尤为重要,并且也要注意五脏之间的调和。再结合临床较为典型的脾虚湿盛型脂溢性脱发病例具体分析"从脾论治"脂溢性脱发的疗效。根据临床症状辨证论治,做到治病求本,标本同治。Seborrheic alopecia is a common dermatological disease.Because it is difficult to treat and affects the appearance,the disease has a greater impact on patients’ mental health,and the incidence is increasing year by year.For the above reasons,this article mainly elaborated the theoretical basis and treatment principles of seborrheic alopecia based on the theory of treating spleen.According to the current research progress on seborrheic alopecia and from the perspective of integrated traditional Chinese and western medicine,it further defined the classification and diagnostic criteria of the disease,mastering the etiology and pathogenesis of seborrheic alopecia from a deep level.Western medicine believes that the main causes of seborrheic alopecia are androgen metabolism disorders,DHT,type 2 5α-reductaseand androgen receptor levels and related to genetics,endocrine disorders,mood,autoimmunity and other factors.TCM believes that the disease is the syndrome of root deficiency and branch excess.The root is spleen and kidney deficiency and the branch factors were internal accumulation of heat and dampness,blood heat,wind and dryness,and blood stasis in the pores and orifices.Due to the gradual improvement of people’s living standards and changes in living habits,people’s diet has also changed.The wine is often used as a pulp,and delusion is the norm.It will damage the spleen and stomachto cause spleen deficiency and dampness.Therefore,among many types,spleen deficiency and dampness syndrome has a large proportion.Therefore,in the treatment of seborrheic alopecia caused by spleen and kidney deficiency,we should first strengthenspleen and warm Yang,then use drugs for eliminating dampness,resolving phlegm,eliminating lipids and activating blood.Normally nourishing spleen is especially important,and we should also pay attention to the harmony between the five internal organs.Combined with the more typical clinical examples of seborrheic alopecia of spleen deficiency and dampness,the effect of treating seborrheic alo

关 键 词：脂溢性脱发 健脾 除湿 化痰 祛脂 活血 补气 养脾护脾 

分 类 号：R758.71[医药卫生—皮肤病学与性病学]