温通化瘀散结法联合箍围-火针法治疗头部脓肿性穿掘性毛囊炎5例  

Warming and Smoothing,Removing Blood Stasis and Knot Combined with Encircling and Fire Needle in the Treatment of 5 Cases of Perifolliculitis Capitis Abscedens et Suffodiens

作　　者：李凯[1] 吴娟[1] 李婧娇 李晨茜 章建兰 曾宪玉[1] 陈柳青[1] 段逸群[1] LI Kai;WU Juan;LI Jingjiao;LI Chenxi;ZHANG Jianlan;ZENG Xianyu;CHEN Liuqing;DUAN Yiqun(Department of Dermatology,the First Hospital of Wuhan,Wuhan 430022,China)

机构地区：[1]武汉市第一医院皮肤科,湖北武汉430022

出　　处：《皮肤科学通报》2024年第3期323-326,共4页Dermatology Bulletin

基　　金：武汉市第一医院“三树成林”梧桐人才培养计划(〔武卫一院2024〕3号)。

摘　　要：目的分析头部脓肿性穿掘性毛囊炎的临床特征及中医证候特点,提高对本病的诊断及中医辨证水平。方法对5例头部脓肿性穿掘性毛囊炎的临床表现、中医证候、中医治则、方药、预后进行回顾性分析。结果5例患者均为青年男性,年龄为19~26岁,平均年龄22.62岁,5例患者皮损以头皮大量结节、囊肿、融合性脓肿为主,伴有明显脓性分泌物、压痛、脱发明显等临床特点。5例患者中2例肥胖(BMI≥30.0 kg/m 2)。5例患者皮疹辨证均符合痰瘀互结证。中医内治均采用温通化瘀散结之法,局部红肿者仙方活命饮加减。外治采用箍围-火针法,箍围使用自制消炎膏配合冲和散,火针针刺后按压排脓。中医药治疗时间为56~180 d,平均时间为101.20 d,5例中3例结节、囊肿完全消退,脓性分泌物消失,遗留色减斑及瘢痕(病例1~3);1例结节消失,囊肿变平,硬化性囊肿缩小(病例4);1例硬化性囊肿略缩小(病例5)。随访6个月后,2例肥胖患者均有复发,继续治疗后复发皮损消失。结论温通化瘀散结法联合箍围-火针法治疗头部脓肿性穿掘性毛囊炎临床疗效较好,值得进一步研究和推广。Objective To analyze the clinical features and traditional Chinese medicine(TCM)syndrome characteristics of perifolliculitis capitis for improving the diagnosis of this disease and the level of TCM syndrome differentiation.Methods The clinical manifestations,TCM syndromes,TCM treatment principles,prescriptions and prognosis of 5 patients with abscedens et suffodiens were retrospectively analyzed.Results All the 5 patients were young men,aged from 19 to 26 years,with an average age of 22.62 years.The skin lesions of 5 patients were mainly characterized by a large number of scalp nodules,cysts and fusion abscess,accompanied by obvious purulent secretion,tenderness and obvious alopecia.Two of the 5 patients were obese(BMI≥30.0 kg/m 2)cases of skin rash were consistent with phlegm and blood stasis syndrome.The TCM internal treatment is warming and smoothing,removing blood stasis and removing knot method,local redness and swelling with Xianfang Huoming decoction.The external treatment was performed by encircling fire needle method.The self-made anti-inflammatory ointment combined with Chonghe powder was used for external treatment.The TCM treatment time was 90-180 days,the average time was 137.82 days.In 5 cases,3 cases of nodules and cysts completely subsided,purulent secretion disappeared,and left color spots and scars(cases 1-3);1 case had nodules disappeared,cyst flattened,sclerotic cyst shrunk(case 4);1 case(sclerotic cyst slightly reduced,case 5).After 6 months follow-up,2 cases of obesity relapsed,and the new skin lesions disappeared.Conclusion The method of warming and smoothing,removing blood stasis and removing knot combined with hoop fire needle therapy in the treatment of head abscess perforator folliculitis has a good clinical effect,which is worthy of further study.

关 键 词：头部脓肿性穿掘性毛囊炎 温通化瘀散结法 箍围-火针法 

分 类 号：R753.34[医药卫生—皮肤病学与性病学]