马林从肝脾辨证论治中老年女性结节性痒疹的临证经验  

MA Lin's Clinical Experience on Treating Middle-Aged and Elderly Women with Nodular Prurigo by Using Syndrome Differentiation and Treatment from Liver and Spleen

作　　者：曾添成 马林 孔连委[1,2] ZENG Tiancheng;MA Lin;KONG Lianwei(Heilongjiang Science of Traditional Chinese Medicine,Harbin 150036,Heilongjiang,China;Heilongjiang Hospital of Traditional Chinese Medicine,Harbin 150036,Heilongjiang,China)

机构地区：[1]黑龙江省中医药科学院,黑龙江哈尔滨150036 [2]黑龙江省中医医院,黑龙江哈尔滨150036

出　　处：《辽宁中医杂志》2023年第10期34-37,I0002,共5页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家中医药管理局(国中医药办人教函[2021]272号);黑龙江省中医药管理局(黑中科教便函[2019]1号)。

摘　　要：结节性痒疹是一种慢性炎症性皮肤病,目前认为其发病机制尚不明确,但与炎症因子、神经心理因素等多种因素有关。根据临床观察及统计学分析,发现在结节性痒疹患者中老年女性占据较大比例,而情绪、心理-躯体因素在女性结节性痒疹患者瘙痒症状中有着重要地位。马林教授经过三十余年的临床观察认为结节性痒疹是由于肝脾功能失常,水气互结于肌肤而成;情绪心理因素易影响肝脾功能,而肝脾功能失调又会加重情绪心理因素,导致结节性痒疹病情加重,故提出从肝脾辨证论治结节性痒疹。对于木郁土未伤者,治当平肝理气,疏散风热;对于土虚木乘湿热壅滞于内者,治当清肝解郁,泻火利湿;对于肝脾两虚,瘀血与湿热蕴结者治当活血清热利湿。Nodular prurigo is a kind of chronic inflammatory skin disease and its pathogenesis is still uncertain.But it is related to various factors such as inflammatory factors and neuropsychological factors.According to clinical observation and statistical analysis,it is found that elderly women account for a large proportion of patients with nodular prurigo,and emotional,psychological and physical factors play an important role in the itching symptoms of female patients with nodular prurigo.Professor MA Lin,after more than 30 years of clinical observation,believes that nodular prurigo is caused by dysfunction of liver and spleen,and the interaction of water and Qi in the skin.Emotional and psychological factors can easily affect liver and spleen function,and dysfunction of liver and spleen function can exacerbate emotional and psychological factors,leading to worsening of nodular prurigo.Therefore,it is proposed to treat nodular prurigo based on liver and spleen syndrome differentiation.For the patients with wood depression without earth injury,the treatment should be calming liver,regulating Qi,dispersing wind and clearing heat.For those who have dampness and heat accumulation due to earth deficiency and wood over-restricting,the treatment should be to clear liver and relieve depression,purge fire and promote dampness.For the patients with liver and spleen deficiency and blood stasis and dampness-heat accumulation,the treatment should be treated by promoting blood circulation,clearing heat and promoting dampness method.

关 键 词：结节性痒疹 肝脾同调 木郁土壅 土虚木乘 土木两虚 

分 类 号：R249[医药卫生—中医临床基础]