从脏腑辨证论“郁乃痤”治疗酒渣鼻  

On“stagnation leads to acne”in treating rosacea from zang-fu differentiation and treatment

作　　者：余涵[1] 林涛[1] YU Han;LIN Tao

机构地区：[1]福建中医药大学,福建福州350122

出　　处：《中医临床研究》2024年第36期23-28,共6页Clinical Journal Of Chinese Medicine

摘　　要：酒渣鼻,又称“酒糟鼻”,是一种好发于面中、主要累及面部血管及毛囊皮脂腺的慢性炎症性痤疮样疾病,以鼻部、两颊等部位出现对称性红斑为特点,反复发作,红斑可持续存在,较难痊愈。《素问•生气通天论篇》:“汗出见湿,乃生痤痱,膏粱之变,足生大丁,受如持虚,劳汗当风,寒薄为皶,郁乃痤。”“郁乃痤”理论概括了酒渣鼻的发病过程和症状特点,对于临床上酒渣鼻的辨病和辨证分析有指导意义。本研究从中医阳气郁遏角度对酒渣鼻进行分型,从脏腑辨证入手分析本病主要脏腑涉及肺、脾、胃、肝等。肺胃热盛型可选用凉血清肺汤治疗,脾虚胃热型可选用加味茵陈蒿汤治疗,肝火上炎型可选用加味逍遥汤。同时结合现代医学技术手段如服用西药四环素类、维A酸类,外用药物包括壬二酸、伊维菌素、水杨酸,并配合光电疗法如595 nm染料激光进行辅助治疗,在临床上取得了较好的疗效。研究参考近几年的文献,归纳中医、中西医对酒渣鼻的研究治疗,为今后临床治疗提供更好的思路。Acne rosacea,which is called“rosacea”in Chinese medicine,is a chronic inflammatory acne-like disease that occurs in the middle of the face and mainly affects facial blood vessels and hair follicles and sebaceous glands.It is characterized by symmetrical erythema in the nose,cheeks and other parts,it recurs and persists,making it difficult to cure.This article analyzes the classification of rosacea from the perspective of yang Qi(气)stagnation and suppression in traditional Chinese medicine,and analyzes zang-fu differentiation and treatment of it,which mainly involves the lungs,stomach,spleen,liver,etc.From the perspective of lung and stomach,the type of excessive heat in the lung and stomach can be treated with Liangxue Qingfei decoction(凉血清肺汤);From the perspective of spleen and stomach,the spleen deficiency and stomach heat type can be treated with modified Yinchenhao decoction(加味茵陈蒿汤);From the perspective of liver,the liver fire ascending and flaming type can select modified Xiaoyao decoction(加味逍遥汤).At the same time,the treatment is combined with modern medical technology,such as taking western drugs tetracycline,vitamin A,topical medication including azelaic acid,ivermectin,salicylic acid.Combined with photoelectric therapy such as 595nm dye laser as adjuvant treatment,good clinical efficacy has been achieved,the therapeutic effect is significant,and the symptoms of rosacea have been well controlled.Plain Questions·Vitality of Human Communicating and Corresponding to the Universe records:“Sweating produces dampness,which leads to acne and heat rash.The transformation of improper diet leads to the growth of herpes in the feet,which is similar to deficiency,and it is easy to lead to acne if there is sweating in the wind,if there is cold and the skin is thin”.The theory of“stagnation leads to acne”summarizes the pathogenesis and symptom characteristics of rosacea.It has guiding significance for the diagnosis and syndrome differentiation of rosacea patients,and can pro

关 键 词：郁乃痤 酒渣鼻 阳气郁遏 脏腑辨证 枇杷清肺饮 

分 类 号：R758.734[医药卫生—皮肤病学与性病学]