程宏斌教授从“治疮不离脾”论治湿毒上泛型囊肿性痤疮  

Professor Cheng Hongbin discusses the treatment of dampness-toxic pantype cystic acne from the perspective of“treating sores without leaving the spleen”

作　　者：刘滢 刘苡辰 郑慧兰 程宏斌[2] LIU Ying;LIU Yichen;ZHENG Huilan(Clinical School of Medicine,Chengdu University of Chinese Medicine,Chengdu Sichuan 610075,China)

机构地区：[1]成都中医药大学临床医学院,四川成都610075 [2]成都中医药大学附属医院皮肤科,四川成都610032

出　　处：《四川中医》2023年第12期21-25,共5页Journal of Sichuan of Traditional Chinese Medicine

基　　金：四川省科学技术厅重点研发计划(重大科技专项)(编号:2022YFS0416);四川省中医药管理局科学技术研究专项课题(编号:2022CP1336,2021MS305);中国出土医学文献与文物研究中心—基于马王堆汉墓出土医书探究的中医原创思维。

摘　　要：囊肿性痤疮是一种以面部大小不等的囊肿、结节为主并伴瘙痒、疼痛,常遗留凹陷性瘢痕为主要临床表现的慢性炎症性皮肤病。程宏斌教授从“治疮不离脾”理论出发,认为湿毒上泛型囊肿性痤疮发病关键在于素体毒邪内蕴,受饮食、情志、劳逸所伤,脾土亏虚,运化无常,酿生湿邪,湿邪与毒邪结合,遇肺胃热盛熏蒸,或脾肾阳虚寒凝,炼成湿毒,湿毒循阳明经上泛头面,日久结成囊肿为病,创新性提出“顾中州、除湿毒、引头面”的原则,治疗上应着眼于脾,顾及肺肾,以健脾益气为主,以除湿解毒为要,上引头面为辅,达里外调和之效。本文通过介绍程宏斌教授从“治疮不离脾”治疗湿毒上泛型囊肿性痤疮临床经验及典型医案,补充了对湿毒上泛型囊肿性痤疮病机与治法的认识思路,进而体会“治疮不离脾”在囊肿性痤疮诊疗中应用的临床思维。Cystic acne is a chronic inflammatory skin disease characterized by cysts and nodules of different sizes of the face,accompanied by itching and pain,and often left with sunken scars as the main clinical manifestations.Based on the theory of“treating sores without leaving the spleen”,Professor Cheng Hongbin believes that the key to the pathogenesis of dampnesstoxic pantype cystic acne lies in the internal pathogenic factors of the body,which is damaged by unbalanced diet,bad emotion and dysregulation.The deficiency of the spleen and the impermanent transport lead to the formation of dampness and toxicity which combines with each other later.Then the comibinaion suffers the fumigation of lung and stomach heat,or the deficiency and cold coagulation of spleen and kidney Yang,and eventually forms a synthesis of dampness and toxicity,which reaches face through the Yangming meridian and causes cysts as a disease over time.According to those theories and facts,Professor Cheng Hongbin innovatively proposed the principle of“taking care of Spleen,discharging the toxification of dampness,and making the drug work on the face”.It means the treatment should focus on the spleen,take account into the lung and kidney,give priority to invigorating the Qi of spleen,enable takeing dehumidification and detoxification as a principle,supplement inducing drug to walk up to face,and achieve the effect of harmonizing inside and outside.By introducing Professor Cheng Hongbin’s clinical experience and typical medical cases of“treating sores without leaving the spleen”in the treatment of acne with toxicity of dampness,this paper supplemented the understanding of the pathogenesis and treatment of acne with dampness and toxicity,and further experienced the clinical thinking of“treating sores without leaving the spleen”in the diagnosis and treatment of acne with cysts.

关 键 词：治疮不离脾 囊肿性痤疮 湿毒上泛 茯苓白术汤 验案 

分 类 号：R249[医药卫生—中医临床基础] R758.733[医药卫生—中医学]