皮肤血络理论的辨证探讨  

Pattern differentiation based on the theory of cutaneous blood collaterals

作　　者：于鸿妲 白彦萍[1,2] YU Hongda;BAI Yanping(Beijing University of Chinese Medicine,Beijing 100029,China;Department of Dermatology and Venereology,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]北京中医药大学,北京100029 [2]中日友好医院皮肤与性病科,北京100029

出　　处：《中华中医药杂志》2024年第1期244-247,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家中医药管理局2021年岐黄学者项目(No.国中医药人教函[2021]203号);国家自然科学基金项目(No.82074445)。

摘　　要：皮肤络脉可分为皮肤血络、皮肤气络、皮肤津络。皮肤血络是有形的络道,具有渗灌营血的功能。皮肤血络病变是皮损产生的前提和基础,是皮肤病的病机核心,分为皮肤血络癥积、皮肤血络失养、皮肤血络外溢三类证候。其中,皮肤血络癥积可细分为瘀阻血络证、湿阻血络证、痰阻血络证,分别对应不同形态的皮损特征。皮肤气络主司皮肤气化,推陈出新,与皮肤感觉功能密切相关。皮肤气络病变为皮肤气络阻滞证、皮肤气络亏虚证,与瘙痒、疼痛密切相关。皮肤津络是布散津液的通道,津络失调,形成皮肤津络亏虚证、皮肤津络湿蕴证。皮肤血络理论的辨证体系,是根据皮损形态和自觉症状推测皮肤络脉的病机,以皮肤血络病变为核心,结合皮肤气络、津络病机,阐述皮肤病的病机特色,为皮肤科中医辨证提供新思路。According to the collateral theory,cutaneous collaterals are consisting of blood collaterals,qi collaterals,and fluid collaterals and blood collaterals in the skin.Among them,the cutaneous blood collaterals refer to vessels,governing the circulating of blood.The pathogenic changes of cutaneous blood collaterals are considered as the preposition and basis,even the core of pathogenesis of the lesion occurrence,which can be categorized into three patterns:Pathological conglomeration in cutaneous blood collaterals,malnourishing of cutaneous blood collaterals,and spillover from cutaneous blood collaterals.Among them,the pathological conglomeration of cutaneous blood collaterals can be subdivided into pattern of blood stasis obstructing the blood collaterals,pattern of dampness obstructing the blood collaterals,and pattern of phlegm obstructing the blood collaterals,with each of them associated with specific lesion characteristics correspondingly.The qi collaterals govern the qi transformation,then promoting the metabolism.It is closely associated with the skin sensation.The pathological changes of cutaneous qi collaterals can be subdivided into pattern of obstruction of qi collaterals and the pattern of deficiency of qi collaterals,both of them are usually followed by itchy and ache.The fluid collaterals are pathways that distributing the fluid.That the function of fluid collaterals is irregulating induces pattern of fluid consumption of collaterals and pattern of fluid accumulation of collaterals.The pattern differentiation as per the theory of cutaneous blood collaterals is a systematic interpretation of pathogenesis in cutaneous collaterals based on the morphological features of lesion and the subjective symptom of patients.It illustrates the unique pathogenesis of skin diseases by emphasizing the pathogenic changes of cutaneous blood collaterals as the core,the pathogenesis of cutaneous qi collaterals and fluid collaterals as the important aspects,providing insights into the pattern differentiation of skin disease

关 键 词：皮肤血络 皮肤气络 皮肤津络 皮肤血络癥积 

分 类 号：R275[医药卫生—中医皮科]