基于“心为五脏六腑之大主”理论辨证论治特应性皮炎  

Syndrome Differentiation and Treatment of Atopic Dermatitis Based on the Theory of Heart Being the Master of Five Zang-and Six Fu-organs

作　　者：马婉婷 王清滢 崔晗[1] 宋艳丽[1] MA Wan-ting;WANG Qing-ying;CUI Han;SONG Yan-li(Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091)

机构地区：[1]中国中医科学院西苑医院,北京100091

出　　处：《世界中西医结合杂志》2024年第4期835-839,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金青年科学基金资助项目(81503447);中国中医科学院科技创新工程课题(CI2021A02310)。

摘　　要：特应性皮炎(Atopic dermatitis,AD)是临床常见皮肤病,发病率逐年上升,患者常伴慢性湿疹,瘙痒剧烈,缠绵难愈,严重影响日常生活质量和精神状态,已经被认为是一种系统性的身心疾病。文中基于《黄帝内经·灵枢·邪客》“心为五脏六腑之大主”中医理论为切入点,从心为火脏、心为血之主、心为神之居这三个方面探讨AD的病因病机,心的生理功能异常导致心火上炎、心血失养、心神失调,从而引起或加重AD相关症状、睡眠障碍等异常精神状态。基于此,AD从心论治,基于“心为五脏六腑之大主”,提出清心泻火、培土济水,养血活血、疏肝健脾,镇心安神、重镇止痒等治则治法,身心同治,多脏同调,形神兼顾,并举医案一隅,以期为中医药治疗AD拓宽思路。Atopic dermatitis(AD)is a common clinical skin disease with an increasing incidence year by year.Patients usually suffer from chronic eczema with intense itching that is persistent and difficult to cure,significantly impacting the quality of their daily life and mental state.AD has been considered a systemic psychosomatic disorder.Based on the classical theory in the Huangdi′s Internal Classic·Spiritual Pivot·Invasion of Pathogenic Factors(Huang Di Nei Jing·Ling Shu·Xie Ke)that heart is the master of five zang and six fu-organs in traditional Chinese medicine(TCM),this paper examined the etiology and mechanism of AD from three aspects:heart as the fire organ,the ruler of blood,and the abode of the spirit.Physiological abnormalities of the heart can lead to up-flaming of heart fire,malnourishment of heart blood,and imbalance of heart spirit,which in turn may initiate or exacerbate the symptoms of AD,related sleep disturbances,and other abnormal mental states.Therefore,in treating AD,addressing the heart is emphasized.Following the principle that the heart is the master of five zang and six fu-organs,this paper proposed therapeutic strategies include cooling the heart,reducing fire,banking up the earth,generating water,nourishing and activating blood,soothing the liver,fortifying the spleen,tranquilizing the heart,calming the spirit,and alleviating itching.A holistic approach in treating both the body and mind,balancing multiple organs,and considering both physical and psychological aspects was recommended,along with a case study to broaden the perspective for TCM treatment of AD.

关 键 词：特应性皮炎 从心论治 心为五脏六腑之大主 

分 类 号：R246.7[医药卫生—针灸推拿学]