四物三色荆防草汤治疗老年皮肤瘙痒症的用药经验  

Medication Experience in the Treatment of Senile Cutaneous Pruritus with Siwu Sanse Jing Fang Cao Decoction

作　　者：于海平 杨梦萍 于增瑞 YU Hai-ping;YANG Meng-ping;YU Zeng-rui(Department of Traditional Chinese M e d i c ine,Yukou Town Community Healthcare Center,Pinggu District,Beijing,101206,China;The Third Clinical Medicine College of Beijing University of Chinese Medicine,Beijing 100029,China;Pinggu District Hospital of Traditional Chinese Medicine,Beijing 101200,China)

机构地区：[1]北京市平谷区峪口镇社区卫生服务中心中医科,北京101206 [2]北京中医药大学第三临床医学院,北京100029 [3]北京市平谷区中医医院,北京101200

出　　处：《中国合理用药探索》2024年第8期116-120,共5页Chinese Journal of Rational Drug Use

摘　　要：老年皮肤瘙痒症常发于60岁及以上人群,其病因病机较为复杂,长期发病会影响患者的睡眠质量和身心健康状态。国医名师于增瑞认为老年皮肤瘙痒症的中医基本病因病机为血虚风燥,老年人气血虚弱,血不养肤,虚风内生,风胜则痒,治疗原则宜养血祛风。于师自拟“四物三色荆防草汤”化裁自当归饮子,当归饮子最初记载于宋代严用和所著的《严氏济生方》,为血虚风燥型皮肤病的常用效方。于师临床上善用四物三色荆防草汤加减化裁治疗老年皮肤瘙痒症,诸药配伍,辨证论治,标本兼施,共奏益气养血润肤、疏风祛邪止痒之功,治疗效果显著。笔者拟从辨证思想、方药源流、组成化裁、临床验案等方面详细介绍于师治疗血虚风燥型老年皮肤瘙痒症的用药经验,为该病的中医临床用药提供新的思路与方法。Senile cutaneous pruritus often occurs in people aged 60 years and above,with complex etiology and pathogenesis,and long-term onset will affect the quality of sleep and physical and mental health of patients.YU Zengrui,a famous Chinese physician,thinks that the basic traditional Chinese medicine etiology and pathogenesis of senile cutaneous pruritus is blood deficiency and wind dryness.As the elderly have weak Qi and blood,blood cannot nourish the skin,generating the endogenous wind,and the excessive wind induces cutaneous pruritus,hence the principle of treatment should be blood-nourishing and wind-expelling.Yu's self-proposed"Siwu Sanse Jing Fang Cao decoction"was is customized from the Danggui yinzi.Danggui yinzi was originally recorded in the"Yanshi Jisheng Fang"written by Yan Yonghe in the Song Dynasty as a commonly used effective prescription for skin diseases of blood deficiency and wind dryness type.Physician Yu made good use of modified"Siwu Sanse Jing Fang Cao decoction"to treat senile cutaneous pruritus through combination of various drugs,syndrome differentiation-based treatment and treatment of both syndrome and etiology,and provided prescription for nourishing qi and blood,moisturizing skin,dispelling wind,eliminating pathogen,and relieving itching,which exhibited significant therapeutic effect.The author intends to introduce physician Yu's medication experience in the treatment of senile cutaneous pruritus of blood deficiency and wind dryness type in detail from the aspects of symptom differentiation,origin and development of prescriptions,combination and modification of components,and clinical cases,etc.,so as to provide new ideas and methods for the clinical medication for the disease.

关 键 词：血虚风燥 老年皮肤瘙痒症 名医经验 中医用药 于增瑞 

分 类 号：R275.9[医药卫生—中西医结合]