白彦萍基于“浊毒内蕴,瘀阻皮络”病机论治淤积性皮炎  

Bai Yanping's Treatment of Stasis Dermatitis Based on Pathological Mechanism of"Turbid Toxin Stasis Blocking Skin Collaterals"

作　　者：张维明 于鸿妲 董晓宛 陈柏林 黄秋晨 白彦萍[2] ZHANG Weiming;YU Hongda;DONG Xiaowan;CHEN Bailin;HUANG Qiuchen;BAI Yanping(Graduate School,Beijing University of Chinese Medicine,Beijing China 100029;Department of Dermatology,China-Japan Friendship Hospital,Beijing China 100029)

机构地区：[1]北京中医药大学研究生院,北京100029 [2]中日友好医院皮肤科,北京100029

出　　处：《中医学报》2023年第12期2623-2627,共5页Acta Chinese Medicine

基　　金：国家自然科学基金项目(82074445);国家中医药管理局2021年岐黄学者支持项目{国中医药人教函〔2021〕203号}。

摘　　要：浊邪蕴积体内,可随脏腑经络运行停于全身,结滞脉络,增加血液的浓稠度、造成血液动力学异常,进一步演化成血瘀,胶着不去而酿毒邪,毒浊瘀互结引起皮肤络脉瘀积及失养的病理状态。浊毒瘀阻滞皮络影响气血津液运输,导致肌肤气血生化乏源,失于濡养,则表现为瘙痒、干燥、萎缩;若浊毒伏藏致皮络营血运行不畅,溢于脉外,潴留于组织皮肤之间则可见水肿、皮肤色素沉着、丘疹、水疱,日久可见局部硬块。临证从皮肤络脉角度认识浊毒“脏腑-络脉-肌表”的致病特点,以“浊毒内蕴,瘀阻皮络”为关键病机探讨淤积性皮炎的辨治原则,并提出“化浊解毒以治其本,逐瘀通络以和气血,益气养络以断其根”的治疗思路,运用化浊通络,通补兼施的治疗大法,以化浊解毒、逐瘀通络、益气养络为原则,重用虫类、藤类药物加强剔络搜邪之功,并结合患者具体情况辨证加减,改善其生活质量。Turbidity accumulates in the body and can stop throughout the body with the movement of the Zang and Fu as well as meridians,blocking the veins,increasing blood consistency,causing hemodynamic abnormalities,and further evolving into blood stasis,which persists and breeds toxins.The combination of toxins,turbidity,and blood stasis can cause skin collateral stasis and loss of nourishment.Turbidity,toxin,and stasis block the skin meridians,affecting the transportation of Qi,blood and body Fluids,leading to a lack of biochemical sources of Qi and blood in the skin.Without nourishment,it manifests as itching,dryness,and atrophy.If the turbid toxin is hidden and causes the skin,collaterals and blood circulation to be impeded,overflowing outside the pulse,and remaining between the tissue and skin,edema,skin pigmentation,papules,blisters can be seen,and local hard lumps can be seen after a long time.From the perspective of skin meridians,we understand the pathogenic characteristics of turbid toxin"Zang and Fu-collateral-muscle and skin surface",and explore the differentiation and treatment principles of stasis dermatitis with the key pathogenesis of"turbid toxin stasis blocking skin collaterals".We propose the treatment concept of"removing turbid and detoxifying to treat in root,expelling blood stasis and clearing collaterals to harmonize Qi and blood,supplementing Qi and nourishing collaterals to break the root of disease",and apply the treatment method of removing turbid and detoxifying,removing blood stasis and clearing collaterals,and supplementing Qi and nourishing collaterals,The wide use of insect and vine drugs can enhance the function of clearing collaterals and searching for pathogens,and combine them with the specific situation of patients to improve their quality of life.

关 键 词：淤积性皮炎 浊毒理论 络病学说 “浊毒内蕴 瘀阻皮络” 白彦萍 

分 类 号：R249.27[医药卫生—中医临床基础]