儿童寻常型银屑病辨证论治临床经验总结  

Clinical experience in treating psoriasis vulgaris in children based on TCM syndrome differentiation

作　　者：陈莎莎 王建青[2] CHEN Shasha

机构地区：[1]汉中市中医医院,陕西汉中723000 [2]山西省中医院,山西太原030012

出　　处：《中医临床研究》2024年第13期97-102,共6页Clinical Journal Of Chinese Medicine

摘　　要：银屑病是一种慢性、复发性、免疫性、系统性皮肤病,临床以红斑、丘疹,其上覆白色鳞屑为主要临床表现,分为寻常型、脓疱型、红皮病型、关节型四种类型,中医俗称“白疕”“松皮癣”等,中医病因病机与多血分热毒炽盛,营血亏耗,瘀血阻滞,化燥生风,肌肤失养关系密切,西医病因病机与遗传、环境、免疫功能等因素密切相关。儿童银屑病则以儿童为发病群体,儿童寻常型银屑病是儿童银屑病中最常见的类型,以点滴状皮损表现最为多见。文章指出中医病因病机还应考虑肺卫受邪致病,西医病因病机常与溶血性链球菌感染相关。在儿童寻常型银屑病的诊疗过程中还需注意儿童“心肝有余,脾肾易虚,肺为娇脏,易实易虚”的特殊体质,结合体质辨证处方用药。王建青主任认为儿童寻常型银屑病以肺卫热毒为主要病机,病变主要在卫分,治疗以轻宣肺卫、透表解毒为主要治则,以牛蒡解肌汤加减组方,擅长运用轻宣透邪之品,其独特的治疗经验在临床应用中取得了满意疗效。Psoriasis is a chronic,recurrent,immune and systemic skin disease.The main clinical manifestations are erythema,papules and white scales.The disease is divided into four types:psoriasis vulgaris,psoriasis pustular,psoriasis erythroderma,and psoriasis arthropathica.Traditional Chinese medicine(TCM)commonly refers to this disease as“Baibi(白疕),Songpi xuan(松皮癣)”,etc..TCM believes that its etiology and pathogenesis are closely related to blood heat and toxin,blood loss,blood stasis,dry skin,and skin dystrophy.Western medicine believes that the disease is closely related to genetics,environment,immune function and other factors.Psoriasis vulgaris in children occurs frequently,with drop like skin damage being the most common manifestation.The article points out that TCM should also consider the pathogenic factors of lung pathogen when exploring the etiology and pathogenesis,which is similar to the hemolytic streptococcus infection in western medicine.In the process of diagnosis and treatment of psoriasis vulgaris in children,we also need to pay attention to the particularity of children’s physique.According to director WANG Jianqing,the main pathogenesis of psoriasis vulgaris in children is pulmonary heat toxicity,and the lesions are mainly at the superficial level.Mild medication and detoxification are the main therapeutic principles.Director WANG selected the modified Niubang Jieji decoction(牛蒡解肌汤),and achieved satisfactory curative effects in clinical application.

关 键 词：儿童寻常型银屑病 辨证论治 临床经验 

分 类 号：R275[医药卫生—中医皮科]