基于朱丹溪“六郁”学说论治带状疱疹  

Treatment of Herpes Zoster Based on ZHU Danxi′s"Six Depressions"Theory

作　　者：徐锐 吕书勤[2] 覃弘宇 郑显达 XU Rui;LYU Shuqin;QIN Hongyu;ZHENG Xianda(The First Affiliated Hospital of Xiamen University,Xiamen 361000,China;Xinjiang Medical University,Urumqi 830099,China)

机构地区：[1]厦门大学附属第一医院,福建厦门361000 [2]新疆医科大学,新疆乌鲁木齐830099

出　　处：《中医药信息》2025年第4期55-59,共5页Information on Traditional Chinese Medicine

基　　金：福建省中医药科研项目(2021zyg178);福建中医药大学校管课题临床专项项目(XB2024206)。

摘　　要：带状疱疹,是由体内水痘-带状疱疹病毒再激活引起的感染性皮肤病,发作时沿单侧周围神经分布,呈带状排列的簇集性小水疱,并伴有剧烈的神经痛。本文阐述朱丹溪“六郁”学说的起源及其理论内涵,并对带状疱疹(HZ)的中医病机进行辨析,指出气郁是前驱期发病的基础,食郁、湿郁、痰郁、火郁为急性期致病的关键,血郁是恢复期后带状疱疹后神经痛(PHN)发作的根本原因,同时结合现代医学对HZ各阶段病理机制的研究成果,对其进行补充论证。进而提出辨“郁”论治策略,前驱期治以气郁达之为纲,方选柴胡疏肝散疏肝健脾,达木郁之气;急性期治以火郁发之为要,方选普济消毒饮疏风解毒,发火郁之邪;恢复期后PHN则治以血郁通之为法,方选血府逐瘀汤活血行气,通血郁之滞。Herpes zoster(HZ)is an infectious skin disease caused by the reactivation of the varicella-zoster virus(VZV)in the body.It typically manifests as a unilateral vesicular eruption along the distribution of a single nerve,accompanied by severe neuralgia.This paper expounds on the origin and theoretical implications of ZHU Danxi's"Six depressions"theory,and analyzes the Traditional Chinese Medicine(TCM)pathogenesis of HZ.It is pointed out that Qi stagnation forms the basis for the prodromal phase of the disease,while food stagnation,dampness stagnation,phlegm stagnation,and fire stagnation are key pathogenic factors during the acute phase.Blood stagnation is the fundamental cause of postherpetic neuralgia(PHN)after recovery.Modern medical research on the pathological mechanisms of HZ at different stages is incorporated to supplement the discussion.A treatment strategy based on the differentiation of"stagnation"is proposed:for the prodromal phase,treatment focuses on resolving Qi stagnation with Xiao Chaihu Decoction to smooth the liver and strengthen the spleen,thus unblocking the Qi.During the acute phase,treatment aims to resolve fire stagnation using Puji Xiaodu Yin to dispel wind and detoxify,expelling the fire stagnation.In the recovery phase,for PHN,treatment focuses on unblocking blood stagnation with Xuefu Zhuyu Decoction to invigorate blood and promote Qi,alleviating blood stagnation.

关 键 词：带状疱疹 六郁 络脉 神经痛 蛇串疮 

分 类 号：R275.9[医药卫生—中西医结合] R275[医药卫生—中医皮科]