扁平苔藓证治经验

Syndrome Differentiation and Treatment Experience of Lichen Planus

目的:总结周宝宽主任医师辨证论治扁平苔藓经验。方法:以医案形式阐述扁平苔藓的病因病机、证型、治法、方药。结果:病因病机为风湿热邪侵袭肌肤,阻滞经络;肝郁气滞,脾失健运,湿热火毒内生;肝肾阴虚,虚火上炎;内外因相合,蕴结肌肤;上述诸因阻于皮肤、黏膜导致肌肤失养形成风热相搏证、血虚风燥证、肝郁气滞证、阴虚内热等证。治疗原则为疏风、清热、利湿、解毒、疏肝、活血、化瘀、滋阴、降火等。常用方剂为消风散、逍遥散、当归饮子、知柏地黄汤。结论:辨证论治扁平苔藓疗效显著。

Objective：To summarize syndrome differentiation and treatment experience of lichen planus in clinic.Methods：Discuss etiopathogenisis,pathogenesis,pattern of syndrome,method of treatment,formulas and medicinals based on medical records.Results：Etiopathogenisis and pathogenesis of lichen planus are wind dampness and heat injury muscle and skin,blocked on meridians;stagnation of QI due to depression of the liver,dys-splenism,damp-heat and virulent fire produced from the interior;hepatic and renal yin deficiency,hyperactivity of deficient fire;coincide of exterior and interior evil,gathering on muscle and skin;those causes blocked in skin and blocked result in failure of skin and muscle to be nourished,generate syndrome of wind-heat fighting,syndrome of blood deficiency wind-dryness syndrome,syndrome of stagnation of QI due to depression of the liver,syndrome of yin asthenia generating intrinsic heat.Treatment principles of lichen planus are,eliminating wind,eliminating heat,damp elimination,neutralize poison,disperse the depressed liver-energy,promoting blood flow,resolve stasis,nourish yin,downbear fire,etc.Frequently used decoction is Xaiofeng Yin,Danggui Yinzi,Zhibai Dihaung Tang.Conclusions：Syndrome differentiation and treatment shows a better therapeutic effect for lichen planus.