甬派名中医陈宁刚运用白花蛇舌草汤治疗痤疮方证玄机参悟  

The Marvellous Enlightenment Through Therapy Come From Prescription to Syndrome of Famous Traditional Chinese Medi⁃cine Doctor CHEN Ninggang in Using Baihua Sheshecao Decoction to Treat Acne

作　　者：顾海宏 赵梦雅 张恋 李梅 陈子杰 陈宁刚 GU Haihong;ZHAO Mengya;ZHANG Lian(Beilun Hospital of Chinese Medicine,Ningbo(315800),China;Huili Hospital of Chinese Medicine;Zheji-ang Chinese Medical University Affiliated Ningbo Hospital of Chinese Medicine)

机构地区：[1]北仑中医院,浙江宁波315800 [2]会理市中医医院 [3]浙江中医药大学附属宁波中医院 [4]浙江中医药大学

出　　处：《浙江中医药大学学报》2024年第7期796-801,共6页Journal of Zhejiang Chinese Medical University

基　　金：宁波市陈宁刚名中医药专家传承工作室建设项目(2022-2024);宁波市重点研发计划项目(2023Z207)。

摘　　要：[目的]介绍甬派名中医陈宁刚运用白花蛇舌草汤治疗痤疮的辨证处方经验。[方法]以古代相关经典论述为基础,对比分析历代医家对于此病病机认识的异同,并结合陈师经验,博古通今,探讨现代患者临床致病因素及发病特征,从而深入剖析陈师运用白花蛇舌草汤的处方结构与方药化裁之内涵,并附验案一则予以佐证。[结果]历代医家针对痤疮发病机制持有不同观念,相关方论不胜枚举。陈师认为甬城位于江南多潮湿,加之现代人不良生活习惯及情志等影响,患者多以肺胃湿热为主要病机,治宜清热利湿、宣疮透表,并依据多年临证经验,自拟白花蛇舌草汤,方中以白花蛇舌草为君清利湿热、散结消疮,臣以茯苓助君通利水湿,佐以白芥子化痰散结,皂角刺破疮透脓,干姜温脾护胃,使以麻黄引诸药透表、消散阴结;以甘草守中调和。文中所附医案,再现了陈师谨守方证病机,解决患者疾病过程中湿、热、痰、瘀等内在矛盾的思辨过程,收效显著。[结论]陈师以肺胃湿热为病机核心,自拟痤疮治疗组方一则,方中既可见清热逐湿之峻猛,又可见温脾护本之巧思,正所谓药简而力专,并根据临证所遇各类变化灵活化裁,疗效显著,其方证辨析思维过程值得进一步探索及研究,以供临床借鉴。[Objective Objective]To introduce the experiences of prescription based on syndrome differentiation of Ningbo famous traditional Chinese medicine doctor CHEN Ninggang in using Baihua Sheshecao Decoction to treat acne.[Methods Methods]Comparing analyse of the similarities and differences of the pathogenesis based on the ancient classics,combining Master CHEN’s experience through both ancient and modern learning to explore the clinical pathogenic factors and pathogenesis characteristics of modern patients,the prescription structure and the connotation of the prescription of the Baihua Sheshecao Decoction are deeply analyzed and a medical case is attached to support.[Results Results]Generations of traditional Chinese medical doctors have held different ideas on the pathogenesis of acne,and the related theories are numerous.Master CHEN believes that Ningbo is located in the south of the Yangtze River,coupled with the influence of bad living habits and emotions of modern people,patients get lung and stomach dampness and heat as the main pathogenesis,so the treatment should clear heat and dampness to promote acne through the skin.Therefore,Master CHEN creates Baihua Sheshecao Decoction which based on many years of clinical experience.In the formula,Herba Hedyotis as king medicine is used to clear the dampness and heat and scatter knot to eliminate sores,Poria cocos as minister medicine is used to help Herba Hedyotis to alleviate water retention,Mustard as assistant medicine is used to reducing phlegm and resolving masses,Gleditsia sinensis as assistant medicine is used to break sores and Rhizoma Zingiberis is to warm the spleen and protect the stomach,Ephedra sinica as guiding medicine is to take all medicine through the skin and dissipate the Yin knot,Radix Glycyrrhizae as guiding medicine is to keep the whole formula in harmony.The case attached reviews Master CHEN’s process of thought from prescription to syndrome,which solves the pathological factors such as dampness,heat,phlegm and blood stasis in the process

关 键 词：皮肤科 痤疮 肺胃湿热 白花蛇舌草 辨证论治 名医经验 陈宁刚 

分 类 号：R751[医药卫生—皮肤病学与性病学]