从血浊理论与氧化应激的相关性探讨银屑病的中医辨治  

Exploring the Traditional Chinese Medicine Diagnosis and Treatment of Psoriasis from the Perspective of Blood Turbidity Theory and Its Correlation with Oxidative Stress

作　　者：邸泽巨 杨素清 张琼 王松岩 DI Zeju;YANG Suqing;ZHANG Qiong;WANG Songyan(Heilongjiang University of Chinese Medicine,Harbin,150040;First Affiliated Hospital,Heilongjiang University of Chinese Medicine)

机构地区：[1]黑龙江中医药大学,黑龙江省哈尔滨市150040 [2]黑龙江中医药大学附属第一医院

出　　处：《中医杂志》2025年第7期690-694,共5页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(81973846)。

摘　　要：氧化应激可以激活多个炎症通路,从而诱发、加重银屑病的皮损表现。血浊是人体受到某些有害因素刺激或不良生活习惯影响而导致血液内杂质丛生、稠厚难行的一种病理现象。基于血浊理论与氧化应激的相关性探讨银屑病的中医辨治,认为脾虚浊伏乃银屑病发病的根源,提出银屑病的病变过程为脾虚浊伏→痰瘀互结→毒邪内生,并以氧化应激为靶点,运用角药进行辨治,确立了早期健脾降浊、未病先防,可选取黄芪-茯苓-白术治疗;中期化痰散瘀、已病防进,偏痰者可选取半夏-陈皮-泽泻治疗,偏瘀者可选取紫草-鸡血藤-首乌藤治疗;后期解毒祛邪、攻补并重,可选取全蝎-土茯苓-熟地黄治疗。Oxidative stress can activate multiple inflammatory pathways,triggering and exacerbating psoriasis lesions.In traditional Chinese medicine(TCM),blood turbidity refers to a pathological condition in which harmful stimuli or unhealthy lifestyle habits lead to an accumulation of impurities in the blood,resulting in increased viscosity and impaired circulation.Based on the correlation between blood turbidity theory in TCM and the pathological changes of oxidative stress in modern medicine,this paper explored the TCM diagnosis and treatment of psoriasis,proposing that spleen deficiency with latent turbidity is the fundamental cause of the disease.The pathological progression of psoriasis was outlined as follows,spleen deficiency with latent turbidity→phlegm and blood stasis intertwining→internal generation of toxic pathogens.Targeting oxidative stress,the study suggests syndrome differentiation and treatment with angle medicine(角药,means three medicinals combination).The treatment strategy divided into three stages.For early stage,strengthening the spleen and directing the turbid downward,emphasizing prevention before onset,with angle medicine of Huangqi(Astragali Radix)-Fuling(Poria)-Baizhu(Atractylodis macrocephalae rhizoma)to treat;for middle stage,resolving phlegm and dispersing blood stasis,preventing disease progression,if patient with more phlegm syndrome treated with angle medicine of Banxia(Pinelliae rhizoma)-Chenpi(Citri reticulatae pericarpium)-Zhexie(Alismatis rhizoma),and if patient with more stasis syndrome treated with Zicao(Arnebiae Radix)-Jixueteng(Spatholobi caulis)-Shouwuteng(Polygonum multiflorum Thunb);for late stage,resolving toxins and dispelling pathogens,balancing both attack and supplementation,with Quanxie(Scorpio)-Tufuling(Smilacis glabrae rhizoma)-Shudihuang(Rehmanniae radix praeparata)to treat.

关 键 词：银屑病 血浊 氧化应激 角药 

分 类 号：R275.9[医药卫生—中西医结合]