从玄府怫郁探讨皮肤疾病核心病机  

Discussion About the Core Pathogenesis of Skin Diseases from Sweat Pore Depression

作　　者：梁未末[1] 叶进[2] LIANG Wei-mo;YE Jin(Huangpu District Hospital of Integrated Traditional Chinese and Western Medicine of Shanghai,Shanghai,China,200010;Shanghai University of Traditional Chinese Medicine,Shanghai,China,201203)

机构地区：[1]上海市黄浦区中西医结合医院,上海200010 [2]上海中医药大学,上海201203

出　　处：《河南中医》2022年第1期46-49,共4页Henan Traditional Chinese Medicine

基　　金：上海市卫生健康委员会中医药传承和科技创新项目(ZYCC2019007)。

摘　　要：玄府既是外邪侵袭机体的入口,又是气血津液流通于体表的通道,还是脏腑经络功能失调形于体表之病所,机体诸因所导致的阴阳、气血、脏腑功能失调,其病理改变必通过玄府表现于皮肤。外邪袭表,玄府阻滞,致皮肤出现瘙痒、灼热、疼痛等;脏腑之玄府郁闭,开阖失常,则致脏腑失和,形成水疱、疱疹;气津不布,肌肤、脏腑失于濡养,又可化燥、生风,致皮肤干燥皲裂;郁滞日久则成血郁,致皮肤不仁,甚者麻木疼痛。反之,玄府郁闭不通,气液不得外达皮毛而致皮肤干燥皲裂、增厚脱屑、瘙痒无度;精血不能濡养脏腑而见黏膜干燥、麻木不仁;水液不循经而外溢,出现皮肤水疱、渗出、溃烂不愈等;痰瘀阻滞则见结节、红斑、紫斑、肿胀、疼痛等。外邪侵袭、热毒壅盛或痰湿阻滞而致玄府腠理闭塞为实郁;气血津液不足,气精亏损致玄府腠理虚衰而自闭为虚郁。多种皮肤损害并见的皮肤疾病常虚实夹杂,治宜开玄府,解怫郁,使气液宣行,气血通和,肌肤得养。A sweat pore is not only the entrance of external pathogens invading the body,but also the channel for the circulation of qi,blood and body fluid on the body surface,or the disease location of visceral meridians dysfunction on the body surface.The pathological changes of yin and yang,qi and blood and visceral dysfunction caused by various factors of the body must be reflected in the skin through sweat pores.If external pathogens attack the surface,and sweat pores are blocked,itching,burning and pain of the skin will occur.If sweat pores of the zang-fu organs are depressed and the opening and closing are abnormal,it will lead to the disharmony of the zang-fu organs and form blisters and herpes.If qi and fluid are not distributed,the skin and viscera will lose nourishment,which can transform into dryness and generate wind,dry and chapped skin will appear.If depression lasts for a long time,it will become blood depression,resulting in poor skin state,even numbness and pain.On the contrary,if sweat pores are blocked,qi and liquid cannot reach the fur,the skin will be dry and chapped,thickened and desquamated,and itching will occur.If the blood essence cannot nourish the viscera,the mucous membrane will be dry and insensitive.If the water overflows without following the meridian,there will be skin blisters,exudation,ulceration,etc.If phlegm and blood stasis accumulate,there will be nodules,erythema,purple spots,swelling,pain and so on.If external pathogens invade,heat toxin is accumulated or phlegm dampness is blocked,it will lead to obstruction of sweat pores interstitial striae and form excess depression.While the deficiency of qi,blood and body fluid will lead to deficiency and decline of sweat pores interstitial striae and form deficiency depression.A variety of skin diseases with common skin damage often have deficiency and excess in complexity.It is advisable to open sweat pores,relieve depression so as to promote qi and liquid circulation,dredge qi and blood,and nourish the skin.

关 键 词：皮肤疾病 玄府 怫郁 玄府怫郁 实郁 虚郁 

分 类 号：R275[医药卫生—中医皮科]