舒琦瑾治疗手足皮肤反应经验总结  

SHU Qijin's Experience in Treating Hand-foot Skin Reaction

作　　者：张瑶 张郜晨茜 赵方敏 寿柳梅 舒琦瑾(指导)[2] ZHANG Yao;ZHANG Gaochenxi;ZHAO Fangmin(The First Clinical Medical School of Zhejiang Chinese Medical University,Hangzhou 310053,China;The First Affiliated Hospital of Zhejiang Chinese Medical University(Zhejiang Provincial Hospital of Chinese Medicine))

机构地区：[1]浙江中医药大学第一临床医学院,杭州310053 [2]浙江中医药大学附属第一医院(浙江省中医院)

出　　处：《浙江中医药大学学报》2024年第6期724-728,共5页Journal of Zhejiang Chinese Medical University

基　　金：浙江省舒琦瑾名老中医专家传承工作室建设项目(GZS2021024)。

摘　　要：[目的]总结舒琦瑾教授治疗手足皮肤反应的临证经验,为临床提供参考。[方法]通过临床跟诊、医案收集和研究分析,从病因病机、分期辨证、治则治法、遣方用药等方面总结舒教授治疗手足皮肤反应的临证经验,并列举经典医案加以佐证。[结果]舒教授提出,“热毒血瘀”为手足皮肤反应的核心病机,贯穿疾病始终,热毒、血瘀、湿邪、血虚、风燥等因素相互兼夹转化。临床上根据手足皮肤反应前、中、后期变化将其分成热毒蕴肤证、湿热瘀阻证、血虚风燥证三种证型,并随证创立“手足宁方”系列方剂。文中所附两则医案呈现了手足皮肤反应三种证型,分别治以清热解毒、凉血消斑,活血化瘀、清热利湿,养血润燥、祛风通络,疗效确切。[结论]舒教授以“热毒血瘀”角度为切入点治疗手足皮肤反应,根据临床证候变化,灵活辨证,随证立方,临床疗效显著,值得推广学习。[Objective]To summarize the clinical experience of Professor SHU Qijin in treating hand-foot skin reaction(HFSR),and to provide some references for clinical practice.[Methods]By following clinical work,collecting clinical cases and analysing research,this paper comprehensively summarizes four key aspects of Professor SHU Qijin's experience in HFSR:etiology and pathogenesis,syndrome differentiation,treatment principles and methods,and curative doctrine and medication.In support of this,classical medical cases are presented below.[Results]Professor SHU Qijin proposes that“heat toxin-induced blood stasis”is the core pathogenesis of HFSR,which occurs throughout the whole disease,with heat toxin,blood stasis,dampness,blood deficiency,wind-dryness and other pathogenic factors mixing and transforming each other.According to the different stages of HFSR,it is classified into three types:heat-toxic syndrome,dampness-heat stasis syndrome,and blood deficiency and wind-dryness syndrome,and a series of formulas called Shouzuning Decoctions(SND)have been created according to the syndromes.The two medical cases represented three types of HFSR,which were treated by clearing heat and detoxifying,cooling blood and eliminating skin lesions;promoting blood circulation and removing blood stasis,clearing heat and dampness;nourishing blood and moistening dryness,dispelling pathogenic wind and dredging collaterals,respectively,with precise therapeutic effects.[Conclusion]Professor SHU Qijin's treatment of HFSR is based on“heat toxin-induced blood stasis”.According to the different clinical symptoms of patients,Professor SHU is flexible in prescribing with remarkable clinical efficacy,which is worth promoting and learning from.

关 键 词：手足皮肤反应 热毒血瘀 辨证论治 手足宁方 医案 临床经验 舒琦瑾 

分 类 号：R658[医药卫生—外科学]