血燥证理论在皮肤科中的应用

Application of Blood Dryness Syndrome Theories in Dermatological Science

血燥泛指人体中津液、血液之干燥、枯涩。血燥证是气血津液辨证《新血证论》中与血热、血虚、血瘀证等同一范畴独立的证。其具有津液、血液功能之紊乱,亦有津液、血液物质基础之改变。其病因以"邪"、"虚"、"瘀"为主。邪有"风"、"热"、"毒"三者,虚有"阴虚"、"血虚"致病。血燥证的辨证论治有其特定的理法方药。血燥证的诊断指征主要根据临床皮肤黏膜、毛发爪甲之燥,以及五脏六腑之燥,实验室有皮肤屏障功能及血液物化特征之异常。血燥证常见于银屑病、干燥综合征、特应性皮炎和鱼鳞病和光感性皮炎等多种皮肤病。血燥证的本质实验研究提示,血燥证患者具有皮肤屏障功能异常、血液流变学物化特征紊乱、体液代谢失调和免疫功能紊乱。中药药物之研究,具有润燥功能的生地黄、山药、益母草、桔梗、首乌、白芨、甘草等均有促进皮肤神经酰胺生成的作用。前述血燥证指标异常的患者经调血、润燥法外用或内服治疗后均获得明显改善,说明血燥证的本质与体液代谢和免疫功能异常相关,调血润燥有改善血燥证上述异常的作用。

Blood dryness refers to the pathological condition of malnutrition in the fluid and blood in the body. Blood dryness syndrome, independent from syndromes like blood heat, blood deficiency and blood stasis, belongs to Qi Xue Jin Ye syndrome differentiation in ＂new blood syndrome theory＂. The function disorders and material changes in fluid and blood can all result in the dryness of blood. The etiology of blood dryness are mainly due to ＂evil＂, ＂deficiency＂ and ＂stasis＂. The ＂evil＂ refers to ＂wind＂, ＂hot＂ and ＂poison＂. And the ＂deficiency＂ includes Yin deficiency and blood deficiency. There are specific treatment principles and formulas for the syndrome of blood dryness. Blood dryness syndrome diagnosis is manifested as dry skin and mucosa, lustreless hair and brittle nail, as well as a failure to moisten the Zang Fu organs, involving abnormal laboratory test results in skin barrier function and the physical and chemical characteristics of blood. This syndrome is common in various skin diseases, such as psoriasis, sjogren syndrome, atopic dermatitis, ichthyosis and photosensitive dermatitis. Experimental study on blood dryness syndrome shows that it is accompanied by abnormal skin barrier function, disorders of blood theology and physical and chemical characteristics, humoral metabolic disorders and immune dysfunction. According to the study of Chinese medicines, a number of herbs with moistening function can promote to produce skin ceramides, such as radix rehmanniae, Chinese yam, motherwort, platycodon grandiflorum, radix polygoni muhiflori, bletilla striata, and licorice root, et al. Patients with blood dryness syndrome receive significant improvement after the topical or oral administration of herbs with harmonizing blood and nourishing dryness, which indicates the etiology and pathogenesis of blood dryness syndrome is related to humoral metabolic disorders and immune dysfunction, and the clinical syndromes of dryness can be improved by regulating blood and moistening dryness.