基于“肝肺同治”理论探讨艾滋病皮肤瘙痒  

Discussion on the treatment of AIDS pruritus based on the theory of“simultaneous treatment of liver and lung”

作　　者：李海玲 谢梦 王军文[2] LI Hailing

机构地区：[1]湖南中医药大学,湖南长沙410828 [2]湖南中医药大学第二附属医院,湖南长沙410005

出　　处：《中医临床研究》2024年第34期67-71,共5页Clinical Journal Of Chinese Medicine

基　　金：国家中医药管理局项目(201507005);湖南省自然科学基金项目(2022JJ30442);湖南省教育厅科学研究项目(20C1424);湖南省研究生科研创新项目(2023CX51)。

摘　　要：皮肤瘙痒是艾滋病患者最常见的并发症之一,患者无原发性皮损,有剧烈瘙痒症状,搔抓后容易引起继发性皮损,反复发作和缠绵难愈是其特点,发作时瘙痒难耐,夜不能寐,严重影响学习、工作和生活。病因的复杂性使艾滋病皮肤瘙痒难以彻底治愈,是临床工作中常见的难题之一。基于中医“肝肺同治”理论,根据艾滋病皮肤瘙痒的疾病特征及病情发生发展的规律,认为肝失升发、肺失清肃,全身气机失调是皮肤瘙痒的重要病机,临床上多采取疏肝理肺、开郁泄实的治法。肝肺源性皮肤瘙痒症主要因湿热疫毒侵袭、肝郁气滞、气郁化火、素嗜肥甘厚味、素体本虚、肺气失于宣降导致,故多分为风邪犯肺袭表证、肝郁痰凝血瘀证、血虚风燥证、肝肾阴虚兼肺虚证论治,治以疏风清热肃肺、疏肝解郁、活血化瘀、健脾化痰、养血润肤祛风、益气滋阴,通过恢复肝的升发功能和肺的清肃功能达到扶正固本、标本兼治的目的,有效缓解患者瘙痒症状,优化治疗效果,降低复发率。此法疗效突出,无不良反应,可提高患者的生活质量,以及增加患者的生存信心,患者耐受性好,值得肝肺源性皮肤瘙痒症患者选用,为艾滋病患者皮肤瘙痒提供更多新的诊疗方案。Pruritus is one of the most common complications of AIDS patients.AIDS patients often have severe pruritus but Pno primary skin lesions.After scratching,it is easy to cause secondary skin lesions,and itching is easy to occur repeatedly and difficult to heal.When the condition is serious,the patient cannot sleep at night,which seriously affects the patient’s life.AIDS pruritus is one of the difficult problems in clinical work because of its complex etiology.Based on the theory of“simultaneous treatment of liver and lung”in traditional Chinese medicine,disease characteristics and disease regularity,it is believed that the loss of liver ascending and descending function,the impairment of lung purging ability,and the imbalance of Qi(气)mechanism of the whole body are the important pathogenesis of AIDS pruritus.Hepatopulmonary pruritus is mainly caused by the invasion of damp heat pathogenic factor,liver depression and Qi stagnation and other factors.Therefore,it is often treated from the perspectives of wind pathogen attacking the lung,blood deficiency and wind dryness,liver and kidney Yin(阴)deficiency and lung deficiency and so on.In clinical practice,many methods are used to restore the ascending and descending function of the liver and the purging function of the lung,so as to achieve the purpose of strengthening the body and consolidating the root cause and treating both symptoms and root causes.This method can effectively relieve the pruritus symptoms of AIDS patients,reduce the recurrence rate,and has no adverse reactions,with high acceptance,can improve the quality of patients life,and increase their survival confidence,providing more treatment methods for AIDS pruritus.

关 键 词：肝 肺 艾滋病 皮肤瘙痒 

分 类 号：R512.91[医药卫生—内科学]