李博鉴中医皮科病案3则——从病例谈同病异治和异病同治

LI Bojian’s 3 Clinical Cases of Dermatological Disease:Different Treatments for Same Disease and Same Treatment for Different Diseases

李博鉴主任医师从事中医临床工作50余年,诊治皮肤病经验丰富,疗效甚佳。该文整理医案3则,体现了博老对中医辨证中同病异治、异病同治的独到见解。案1为带状疱疹,博老诊为"大头瘟",方用普济消毒饮加减,取其疏风散邪、清热解毒,效若桴鼓。案2为银屑病(白疕)、案3为慢性湿疹,博老辨为湿热内滞,宜清热燥湿运脾,缓图收效,皆投以芩连平胃散加味化裁。大家学习中医当以读经典、跟名师为正途。学经典须勤读强记,跟师则需勤思理法方药,明辨病因病机,方能在临床举一反三,临症不乱。

LI Bojian has rich clinical experience in diagnosis and treatment of dermatological disease.The following cases will show LI’s insightful opinion on the TCM idea of different treatments for same disease and same treatment for different diseases.In Case 1,he diagnosed the patient,who had severe herpeszoster on face,with "Da Tou Wen"(as infection with swollen head).The patient was cured one week later,only taking orally Puji Xiaodu drink,which was the specific drugs against "Da Tou Wen".LI diagnosed the TCM syndrome of the psoriasis patient in case 2 and the chronic eczema patient in case 3 with dampness-heat type,giving the similar prescription of Qinlian Pingwei powder.