李传芬运用柴胡桂枝汤治疗老年性皮肤瘙痒症经验  

Li Chuanfen's Experience of Treating Senile Pruritus with Bupleurum and Cinnamon Twig Decoction

作　　者：刘建材 叶灵兰[1] 郑涵尹 潘卉 LIU Jiancai;YE Linglan;ZHENG Hanyin;PAN Hui(Zigong Hospital of Traditional Chinese Medicine,Zigong,Sichuan,China,643000)

机构地区：[1]自贡市中医医院,四川自贡643000

出　　处：《河南中医》2023年第7期1019-1022,共4页Henan Traditional Chinese Medicine

摘　　要：李传芬教授认为,老年性皮肤瘙痒症的发生与正气不足、外邪侵袭、情志不畅密切相关。柴胡桂枝汤既作用于肌肤腠理,调和营卫,祛邪扶正,又作用于半表半里,和解少阳之枢机,畅达情志,并且气血同调,痰饮兼治,契合老年性皮肤瘙痒症“体虚受风”“枢机不利”病机。气虚者,加黄芪、白术益气固表;阴血亏虚者,重用芍药,加当归、熟地黄、何首乌、鸡血藤等滋阴养血;阳虚者,加附子、肉桂、补骨脂、蛇床子等;兼风寒者,去黄芩,加麻黄、桂枝、防风,或合用桂枝麻黄各半汤;兼风热者,加金银花、菊花、连翘、牛蒡子;兼风湿者,加薏苡仁、地肤子、白鲜皮祛风除湿;风邪入络、瘙痒剧烈者,加全蝎、乌梢蛇熄风通络。Professor Li Chuanfen believes that the occurrence of senile pruritus is closely related to insufficient healthy qi,invasion of external pathogens,and poor emotional state.Bupleurum and Cinnamon Twig Decoction not only acts on skin interstitial striae to regulate nutrient and defense qi,dispel pathogenic factors and reinforce healthy qi,but also acts on half exterior and half interior to reconcile the pivot of lesser yang,relax emotions,harmonize qi and blood,and remove phlegm retention simultaneously,which is in line with the pathogenesis of senile pruritus characterized by"deficiency of the body due to wind"and"dysfunction of pivot".For qi deficiency,Huangqi(Radix Scutellariae)and Baizhu(Rhizoma Atractylodis Macrocephalae)are added to replenish qi and consolidate the exterior.For deficiency of yin and blood,Shaoyao(Radix Paeoniae Alba seu Rubra)is heavily used,combined with Danggui(Radix Angelicae Sinensis),Dihuang(Radix Rehmanniae),Heshouwu(Radix Polygoni Multiflori),Jixueteng(Caulis Spatholobi),etc.to nourish yin and blood.For yang deficiency,Fuzi(Radix Aconiti Lateralis Preparata),Rougui(Cortex Cinnamomi),Buguzhi(Fructus Psoraleae),Shechuangzi(Fructus Cnidi),etc.are added.For those who also suffer from wind and cold,Huangqin(Radix Scutellariae)is removed,while Mahuang(Herba Ephedrae),Guizhi(Ramulus Cinnamomi)and Fangfeng(Radix Saposhnikoviae)are added,or half Cinnamon Twig Decoction and half Ephedra Decoction is combined.For those who also experience wind-heat,Jinyinhua(Flos Lonicerae Japonicae),Juhua(Flos Chrysanthemi),Lianqiao(Fructus Forsythiae)and Niubangzi(Fructus Arcti)are added.For those who also suffer from rheumatism,Yiyiren(Semen Coicis),Difuzi(Fructus Kochiae)and Baixianpi(Cortex Dictamni)are added to remove wind and dampness.For those with wind pathogen entering the meridians and severe itching,Quanxie(Scorpio)and Wushaoshe(Zaocys)are added to eliminate wind and dredge collaterals.

关 键 词：老年性皮肤瘙痒症 柴胡桂枝汤 《伤寒论》 张仲景 李传芬 

分 类 号：R275.958.31[医药卫生—中西医结合]