解痉法分型辨治皮肤瘙痒症  

Classification differentiation and treatment of cutaneous pruritus by spasmotherapy

作　　者：宋玮 张钟艺 贾波[1] 王楷 卓兴卫 肖敏[1] 陈明岭[1] 沈涛[2] SONG Wei;ZHANG Zhong-yi;JIA Bo;WANG Kai;ZHUO Xing-wei;XIAO Min;CHEN Ming-ling;SHEN Tao(Chengdu University of TCM,Chengdu 610075,China)

机构地区：[1]成都中医药大学,成都610075 [2]成都中医药大学基础医学院

出　　处：《中华中医药杂志》2022年第5期2471-2474,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家重点研发计划(No.2018YFC1704104)。

摘　　要：文章分析了遵陈潮祖“膜腠三焦”理论运用解痉法治疗皮肤瘙痒症。膜腠三焦在生理上是津、气升降出入之通道,在病理上是病邪入侵之道路,在治疗过程中是祛邪外出之路径。笔者认为皮肤瘙痒症的核心病机为风挟它邪客于腠理,致膜腠挛急,津气不利,血运为其阻。外邪以风邪为主,风邪郁滞肌腠,不得升散发越,则气血津液运行不畅,筋膜腠理挛急不舒,以致气滞、血郁、湿阻,显现为红斑、风团、瘙痒等症。临证运用解痉法分型辨治皮肤瘙痒症,可获良效。具体包括:寒郁肌表证,治以调和营卫、柔肝缓急,方以桂枝麻黄各半汤合葛根汤加减;风热郁表证,治以疏风散邪、利气行津,方以简化消风散加减;湿热蕴肤证,治以清热祛湿、祛风解毒,方以马齿苋汤加减;火热血热证,治以清热凉血、凉肝息风,方以凉血消风散加减;血虚风燥证,治以养血补血、补虚止痒,方以当归饮子加减。This paper analyzes the application of spasmolysis in the treatment of pruritus according to CHEN Chaozu’s‘fascia-interstice-Sanjiao’theory.Fascia-interstice-Sanjiao is physiologically a pathway for the rise and fall of fluid and qi,pathologically a pathway for the invasion of pathogens,and in the course of treatment,a path for removing pathogens.The authors think that the core pathogenesis of skin pruritus is wind evil detain in interstice,leading to fascia and interstice convulsion,fluid and qi not running smoothly,blood circulation for its resistance.Wind evil is the main cause of pruritus.Wind evil stagnation interstice,and can not send out more,and then fluid and qi imbalance and fascia clonus,so that qi stagnation,blood stagnation,wet resistance,and on the skin for erythema,wind group,itching and other symptoms.The clinical application of spasmolysis method for classification and treatment of pruritus can obtain good effect.Specifically including:wind and cold evil invasion syndrome,treatment to adjust the Yingwei,nourish liver,with Guizhi Mahuang Geban Decoction and Gegen Decoction;wind and heat evil invasion syndrome,treatment to dispel wind evil,adjust local liquid circulation,with Jianhua Xiaofeng Powder;damp and heat evil invasion syndrome,treatment to dispel wind and heat evil,with Machixian Decoction;fire and heat invasion syndrome,treatment to cool liver blood and quell wind evil,with Liangxue Xiaofeng Powder;wind formation from blood deficiency syndrome,treatment to nourish blood and replenish blood,with Dangui Yinzi Decoction.

关 键 词：筋膜 腠理 陈潮祖 皮肤瘙痒症 辨证论治 膜腠三焦 挛急 解痉法 

分 类 号：R275.9[医药卫生—中西医结合]