基于“伏阳”理论的青春期女性痤疮发病机制及治疗探讨  

Discussion on the pathogenesis and treatment of acne in adolescent women based on the Fuyang heory

作　　者：陈少禹 王天乐 崔云竹[2] CHEN Shaoyu

机构地区：[1]山东中医药大学,山东济南250013 [2]山东中医药大学附属医院,山东济南250011

出　　处：《中医临床研究》2024年第5期137-140,共4页Clinical Journal Of Chinese Medicine

摘　　要：痤疮是一种好发于面部,且以脓疱、囊肿、结节、丘疹等皮损为主要临床表现的慢性炎症性疾病。研究发现,随着社会节奏及饮食结构的变化,青春期女性已成为痤疮的多发人群,严重影响其生理及心理健康,因此痤疮的治疗是一个亟待解决的问题。由于现代医学对于痤疮的发生机制尚未明确,故而国内外目前尚未有完善的治疗体系,抗生素治疗易破坏皮肤微生态且易致痤疮反复发作。中医学认为痤疮的产生以气血拂郁为直接原因,痤疮的记载最早可追溯至《黄帝内经》,其诊疗理论经过历代医家发展日臻完善。文章基于“伏阳”理论这一新视角解读痤疮,提出因郁而化生的“伏阳”为痤疮的关键病机,认为“伏阳”为少阳之病,病位在膜原,因郁而结,以畅达为散;其根本在乎肝脾两脏,或因肝木郁结,或因脾虚湿盛而生。中医治疗痤疮需抓住虚实、寒热之纲领,综合诊察,以正确判断患者虚实、寒热的轻重,以和解为要,做到驱邪不伤正、扶正不恋邪。文章结合病案分享以“和解”法治疗青春期女性痤疮的成功经验,以期为临床诊疗开拓新思路。Acne is a chronic inflammatory disease that often occurs on the face with pustules,cysts,nodules,papules and other lesions as the main clinical manifestations.Moreover,studies have found that with the changes of social rhythm and diet structure,adolescent females have become the frequent population of acne,which seriously affects their physical and mental health.Therefore,the treatment of acne is an urgent problem to be solved.As the mechanism of acne occurrence is not clear in modernA medicine,there is no perfect treatment system at home or abroad,and antibiotic treatment is easy to destroy the skin microecology and prone to recurrent acne.Traditional Chinese medicine believes that the direct cause of acne is the depression of Qi(气)and blood.The earliest records of acne can be traced back to Huangdi NeiJing(《黄帝内经》),and its diagnosis and treatment theory has been perfected day by day through the development of successive doctors.This paper discusses the interpretation of acne based on the new perspective of Fuyang(伏阳)theory,and proposes that Fuyang caused by depression is the key pathogenesis of acne,and believes that Fuyang is the disease of Shaoyang(少阳).Moyuan(膜原)is the location of this disease,which is caused by depression,and is cured by openness.Its fundamental lies in the liver and spleen two viscera,or because of liver stagnation,or because of spleen deficiency and abundant dampness.TCM treatment of acne needs to grasp the program of deficiency and abundance,cold and heat for comprehensive examination,to correctly judge the severity of the patient’s deficiency or abundance,cold or heat.Reconciliation is the key of curing acne,eliminating evil without harming good,and protecting good without promoting evil.The article shared the successful experience of treating adolescent female acne with the method of reconciliation by medical records,in order to open up new ideas for clinical diagnosis and treatment.

关 键 词：伏阳 青春期 痤疮 痞坚 和解 

分 类 号：R758.733[医药卫生—皮肤病学与性病学]