蔡圣朝治疗黄褐斑经验探析

Analysis on CAI Shengchao′s Clinical Experience on Treating Chloasma

黄褐斑是以颜面部出现大小不一,对称分布的棕色斑块为主要临床表现的皮肤病。有研究表明与遗传因素、光照、人体激素水平及其异常分布的受体、血管内皮功能和血液流变学、精神因素等多种因素有关。西医治疗上主要以口服维生素C、酪氨酸酶抑制剂、外用激光照射为主。近年来黄褐斑患者逐渐增加,色斑持久不易消退,严重影响患者的心情和生活质量。蔡教授认为黄褐斑以肝郁气滞、肾虚精亏、气血运行受阻为本,风邪、燥邪、痰饮等病理因素停滞为标,将黄褐斑辨证分型为肝郁生斑、肾虚生斑、脾虚生斑、火躁生斑、久病生斑5种,临证选药时顺应脏气法时,调和气血;穴位选取运用双萼选穴法,针刺以毛刺法结合刺血拔罐;强调既要通过内治法重视脏腑气血阴阳的调理,也要通过外治法改善外在症状,通调三焦气血;此外提出医者要修神治神,对患者身心同治,在长期临床实践中获得了满意疗效。

Chloasma is a skin disease characterized by brown patches of different sizes and symmetrical distribution on the face.Studies have shown that it is related to genetic factors,light,human hormone levels and their receptors,vascular endothelial function and hemorheology,mental factors and other factors.Western medicine treatment mainly includes oral vitamin C,tyrosinase inhibitor and external laser irradiation.In recent years,the number of patients with chloasma is increasing gradually,and the stains are not easy to fade,which seriously affects the mood and quality of life of patients.Professor CAI believes that chloasma is based on liver Qi stagnation,kidney deficiency and deficiency of essence,Qi and blood operation obstruction,and pathological factors such as wind evil,dryness evil,phlegm and fluid retention as the pathological products.The sydnromes of chloasmacan be divided into five types:liver stagnation,kidney deficiency,spleen deficiency,fire mania and chronic illness.When selecting drugs for syndromes,Qi and blood should be coordinated while adhering to the Zang-organs Qi method.The acupoints were selected by double calyx method,and the burr method combined with stabbing blood cupping was used for acupuncture.It is emphasized that we should not only pay attention to the regulation of Qi,blood and Yin and Yang of Zang-Fu organs through internal treatment,but also improve the external symptoms through external treatment and regulate the three Jiao Qi and blood.In addition,it is suggested that the doctor should repair the spirit and treat the spirit,and treat the patients both physically and mentally,which has obtained satisfactory curative effect in long-term clinical practice.