唐启盛从心肝火旺论治拔毛癖经验  

TANG Qisheng's experience in treating trichotillomania from heart and liver effulgent fire

作　　者：李艺 杨歆科 郑琴 唐启盛 曲淼 LI Yi;YANG Xinke;ZHENG Qin;TANG Qisheng;QU Miao(Department of Brain Diseases,Third Affiliated Hospital of Beijing University of Chinese Medicine,Beijing 100029;Department of Neurology,Xuanwu Hospital,Capital Medical University,Beijing 100053)

机构地区：[1]北京中医药大学第三附属医院脑病科,北京100029 [2]首都医科大学宣武医院神经内科,北京100053

出　　处：《北京中医药》2025年第2期172-175,共4页Beijing Journal of Traditional Chinese Medicine

基　　金：国家中医药领军人才支持计划——岐黄学者项目(国中医药人教发〔2018〕12号);唐启盛全国名老中医药专家传承工作室项目(国中医药人教发〔2016〕42号);首都卫生发展科研专项重点攻关项目(首发2020-1-2011)。

摘　　要：唐启盛教授认为,拔毛癖的发病主要责之于心、肝两脏,若情志刺激,或学习与家庭压力过大,情绪压抑,导致肝气不舒,郁而化火,心火燔炎,扰动神魂,筋脉约束失司,轻则爪甲不宁,重则躁扰拔毛。日久耗伤肾精阴液,水不济火,毛发失于固托,加重拔毛所致脱发。本病虚实夹杂,以肾虚为本、心肝火旺为标。治疗上采用“急则治其标、缓则治其本”的基本原则,初期以清心平肝、镇静安神为主;待病情缓解后,中期以清心平肝法为主、补肾滋阴法为辅;后期以滋肾水、散瘀结、畅通气血为要。临证中,唐教授遵循病机,结合脏腑辨证,重视病证合参,探晓标本虚实,随证遣方用药,并自拟清心平肝汤化裁治疗本病,疗效较佳。Professor TANG Qisheng believes that the main responsibility for the occurrence of trichotillomania lies in the heart and liver.If emotions are stimulated,or if there is excessive pressure from studying and family,emotions are suppressed,resulting in liver qi not being relaxed,depression turning into fire,heart fire burning inflammation,disturbance of the soul,loss of muscle and vein restraint,mild cases of restless claws and nails,and severe cases of restlessness in hair pulling.Long-term consumption can damage the kidney essence and yin fluid,causing water to be inadequate for fire and hair loss due to loss of stability,exacerbating hair loss caused by hair pulling.This disease is characterized by a mixture of deficiency and excess,with kidney deficiency as the foundation and excessive heart and liver effulgent fire as the criteria.In terms of treatment,the basic principle of"treating the target in case of urgency and treating the root cause in case of delay"is adopted.In the initial stage,the main focus is on clearing the heart,calming the liver,and calming the mind.After the condition is relieved,in the mid-term,the main method is to clear the heart and calm the liver,supplemented by the method of tonifying the kidney and nourishing yin;In the later stage,it is important to nourish the kidneys,disperse blood stasis,and unblock qi and blood.In clinical practice,Professor TANG Qisheng followed the pathogenesis,combined with the differentiation of internal organs,attached importance to the combination of disease and syndrome,explored the deficiency and excess of the specimen,prescribed medication according to the syndrome,and self-formulated Qingxin Pinggan Decoction for the treatment of this disease,with good therapeutic effects.

关 键 词：拔毛癖 心肝火旺 清心平肝汤 名医经验 

分 类 号：R24[医药卫生—中医临床基础]