基于玄府理论探讨防风通圣散治疗脂溢性脱发  

Treating seborrheic alopecia with Fangfeng Tongsheng San based on the Xuanfu theory

作　　者：温雅轩 张彬彬 张林[1] 黄思齐 李佳欢 倪佳慧 WEN Yaxuan

机构地区：[1]辽宁中医药大学,辽宁沈阳110000 [2]中国人民解放军陆军第79集团军医院,辽宁沈阳111000

出　　处：《中医临床研究》2024年第31期100-103,共4页Clinical Journal Of Chinese Medicine

基　　金：辽宁中医药大学大学生创新创业训练计划项目资助(202210162010);辽宁省博士科研启动基金项目(2022-BS-206);校级自然科学类重点项目(2021LZY048);校级自然科学项目(2021LZY007)。

摘　　要：脂溢性脱发是一种毛囊微型化脱发类疾病,中医学家多从脏腑角度辨证施治,鲜有医家将其与皮毛、腠理联系起来。研究从“玄府”等微观层面入手分析,将刘完素的“玄府理论”灵活应用到脂溢性脱发的治疗中,并结合刘完素的理论经验系统阐述玄府的内涵与作用机制,指出“玄府郁闭”导致气、血、津液输布失司,使毛囊失去营养濡润,是导致脱发的主要病机,并基于玄府“贵开忌阖”的特性,从气血亏虚、风热搏结、湿热内蕴3个方面论述玄府通利的重要性,提倡应用刘完素创制的防风通圣散治疗脂溢性脱发。在治法方面,强调防风通圣散蕴含清、宣、通三法,并从“清”玄府之热、“宣”玄府之郁、“通”玄府之结3个方面论述防风通圣散善于开玄府之密闭的功用特点,阐明其药物功效与脂溢性脱发的病因病机相契合,为防风通圣散治疗脂溢性脱发的可行性提供可靠的理论支撑。同时善于利用风药较强的开发流通之性提高疗效,共奏开通毛窍、通畅气机、流通津血之效,使发有所养,生长旺盛。末尾附临床案例,为脂溢性脱发的现代治疗提供新的启发和借鉴,另外总结目前存在的问题和不足之处,期待日后出现更优的治疗方案。Seborrheic alopecia is a kind of hair follicle miniaturization alopecia disease.Traditional Chinese medicine practitioners mostly diagnose and treat the disease based on viscera differentiation,while few medical practitioners connect it with skin,hair,and the texture of muscles and skin.Based on the analysis of Xuanfu(玄府)and other micro levels,LIU Wansu’s Xuanfu theory is flexibly applied to treat seborrheic alopecia in clinical practice,and the connotation and action mechanism of Xuanfu is systematically elaborated according to LIU Wansu's theoretical experience.It is pointed out that the main pathogenesis is the transmission failure of Qi(气),blood,and body fluid cuased by Xuanfu stagnation and closure,which makes hair follicles lose nutrition and moistening,thus leading to hair loss.Based on the characteristic of advocating open and avoiding closure of Xuanfu,the importance of unimpeded Xuanfu is discussed in the paper from the three aspects of Qi and blood deficiencies,wind-heat stagnation,and damp-heat internal accumulation,and Fangfeng Tongsheng San(防风通圣散)created by LIU Wansu is advocated to be used clinically to treat seborrheic alopecia.In terms of the treatment of seborrheic alopecia,it is emphasized that Fangfeng Tongsheng San has three effects of clearing,releasing,and dredging,and it is proposed that the functional characteristics of Fangfeng Tongsheng San of opening Xuanfu from the three aspects of clearing heat of Xuanfu,releasing depression of Xuanfu,and dredging stagnation of Xuanfu.It is clarified that the efficacy of Fangfeng Tongsheng San is compatible with the etiology and pathogenesis of seborrheic alopecia,which provides reliable theoretical support for the feasibility of Fangfeng Tongsheng San in the treatment of seborrheic alopecia.At the same time,the strong dredging and circulating function of Feng medicine(风药)is exerted well to improve the therapeutic effect,namely the effects of opening hair orifices,smoothing Qi movement(气机),and promoting body fluids and blood

关 键 词：防风通圣散 脂溢性脱发 玄府理论 

分 类 号：R22[医药卫生—中医基础理论]