基于“燥湿同形同病”论治鱼鳞病  

Treating ichthyosis based on“dryness and dampness from the same source causing same disease”

作　　者：宋玮 张钟艺 凌桂华 饶响书 卓兴卫 肖敏[1] 陈明岭[1] 沈涛[1] SONG Wei;ZHANG Zhongyi;LING Guihua;RAO Xiangshu;ZHUO Xingwei;XIAO Min;CHEN Mingling;SHEN Tao(Chengdu University of Traditional Chinese Medicine,Chengdu 610075,China)

机构地区：[1]成都中医药大学,成都610075

出　　处：《北京中医药大学学报》2023年第1期110-114,共5页Journal of Beijing University of Traditional Chinese Medicine

基　　金：国家重点基础研究发展计划项目(No.2013CB532005);国家重点研发计划项目(No.2018YFC1704104);国家自然科学基金青年科学基金项目(No.82004380);四川省科技厅应用基础研究项目(No.2019YJ0613)。

摘　　要：燥与湿反映了自然界气候的变化,于人体而言,则可概指津液盛衰的两种状态。两者看似相反、互制,实则相关、共存,并能够相互转化。临床上,鱼鳞病的鳞屑颜色和部位可以反映燥极似湿、湿极似燥的皮损特点,此为“燥湿同形”;鱼鳞病的临床特征可以反映燥湿夹杂的病理状态,此为“燥湿同病”。从“燥湿同形同病”论治鱼鳞病,认为鱼鳞病核心病机为外燥内湿,或湿郁燥生,或燥壅湿阻,或燥湿互化。治法上若单纯养阴则碍湿,若过用温燥则阴亏更胜,必润燥相济,相反相成,方可奏效。故内湿以运脾调气祛湿,斡旋中焦;外燥以开玄养阴润燥,布散津液。本文从“燥湿同形同病”论治鱼鳞病,临证予以润肤饮合化裁异功散加减治之,以期为临床治疗鱼鳞病提供又一思路。Dryness and dampness reflect the change of climate in nature.For the human body,they can refer to the rise and fall of body fluid in two states.They seem to be opposite and mutually controlled,but in fact they are related,coexist and can be transformed into each other.Clinically,the color and position of ichthyosis scales show the skin lesions characteristic of“extreme dryness similar to wet and extreme wet similar to dryness”,meaning that“dryness and dampness coming from the same source”.The symptoms and signs of ichthyosis can reflect the combination of dryness and dampness,which means“dryness and dampness causing same disease”.According to the theory of“dryness and dampness from the same source causing same disease”,the core pathogenesis of ichthyosis is considered to be external dryness and internal dampness,or dampness depression and dryness production,or dryness blocking and dampness obstruction,or dryness and dampness interaction.For the treatment of ichthyosis,if the yin is simply raised,the evil of dampness would be more,and the excessive use of warm or dry natured herbs would aggravate yin deficiency,since they complement each other.Therefore,the only choice for treatment is the combination of nourishing yin and drying dampness.Interior dampness should be treated by strengthening the spleen,regulating qi,and mediating middle energizer to remove the evil of dampness,while exterior dryness by opening the sweat pore(xuanfu),nourishing yin and dispersing body fluid to moisten dryness.Based on the theory of“dryness and dampness from the same source causing same disease”,we found the combination of Runfu Decoction and Huacai Yigong Powder is effective in the treatment of ichthyosis.

关 键 词：鱼鳞病 阴阳互根 燥湿同形同病 润燥相济 健脾养阴 

分 类 号：R275[医药卫生—中医皮科]