从血分论治痤疮的思考与体会

The Thinking and Experience of Treating Acne from Xuefen

痤疮病位在心,病机虽以阳热偏盛,肺经血热为多,但临床也的确存在一部分因血虚、肝郁血逆、血瘀等血分异常所引起的痤疮患者。治疗这部分患者应运用补血、调血、活血化瘀等方法,如针对血热型痤疮应以补血养血、清肺凉血为主要治法,当选具有健脾养血、宁心安神功效的归脾汤和清肺泻热功效的枇杷清肺饮;针对肝郁型痤疮应以疏肝理气、调血清热为主要治法,当选具有养血疏肝、理血调经作用的丹栀逍遥散配合具有清肺邪热作用的黄芩泻白散;针对内热偏盛型、结节型、囊肿型等其他类型的痤疮,又当分别以加强清热凉血、活血化瘀、化痰散结,活血化瘀作为基本治法,采用相应的方药进行调治。除此之外,痤疮也可采用外治法进行治疗,而外治法的药物选择也应当遵循辨证论治的基本原则,以清肺凉血为基本治法,根据患者证型的不同,辅以养血、理血、活血化瘀、凉血等不同治法进行治疗。

The location of acne is in the heart. Although the pathogenesis of acne is mainly due to yang fever and blood heat of lung channel,but there are indeed some patients with acne caused by abnormal of Xuefen such as blood deficiency,blood reverse caused by stagnation of liver qi and blood stasis. Treatment of this part of patients should use methods. of replenishing blood,regulating blood,promoting blood circulation for removing blood stasis and so on. For example,for the blood-heat type acne,the main treatment method should be to nourish blood,clear lung and cool blood,and choose Guipi Decoction which has the functions of strengthening spleen and nourishing blood,calming heart and tranquillization,and choose Pipa Qingfei Decoction which has the function of clearing lung and releasing heat. For the stagnation of liver qi type acne,the main treatment method should be to soothe the liver and regulate qi,regulate blood and clearing heat,and choose Danzhi Xiaoyao Powder which has the functions of nourishing blood and soothing the liver,regulating blood circulation and regulating menstruation,cooperating with Huangqin Xiebai Powder which has the function of clearing lung and releasing heat. For other types of acne such as internal heat partial type,nodular type, cyst type and so on,it is also necessary to strengthen the clearing heat and cooling blood,promoting blood circulation for removing blood stasis,dissipating phlegm and resolving masses,promoting blood circulation and eliminating stasis as the basic treatment method. Use the corresponding prescription for treatment. In addition,acne can also be treated by external treatment,and the choice of drugs for external treatment should follow the basic principles of treatment based on syndrome differentiation,with clearing lung and cooling blood as the basic treatment,according to the different types of patients,supplemented by different methods such as nourishing blood,regulating blood,promoting blood circulation for removing blood stasis and cooling blood.