中医防治慢性荨麻疹的临床用药思路与对策

Clinical views and strategy of Chinese medicine in the prevention and treatment of chronic urticaria

慢性荨麻疹的病因复杂,目前认为其发病可能与自身免疫有关,常见的诱因有食物、药物、感染、理化因素、内分泌、精神或遗传因素。临床上大约有75%的患者找不到确切的诱因,给药物防治带来很大困难。中医认为慢性荨麻疹的病因病机是本虚标实,本虚主要是心、肝、脾、肾等五脏虚损及脏腑功能失调,标实乃风、寒、湿、燥、热等邪气侵袭和积聚;治疗上多采用标本兼治,宜祛风除湿、凉血润燥、泻火解毒与补虚益损相结合;在慢性荨麻疹的预防上,中医强调扶正固本,调理脏腑,防止复发。本文还结合临床实践,针对临床困扰的常见问题,提出了一些具体的用药心得和体会。

The pathogenesis of chronic urticaria is complex and it is considered that the etiology of chronic urticaria may be related to autoimmunity. Its common inducements are food, medicine, infection, physical and chemical factors, endocrine, mental or genetic factors. In clinic, about 75% of patients can not find the clear causes, which brings difficulty to drug prevention and treatment. According to traditional Chinese medicine (TCM), the etiology and pathogenesis of chronic urticaria are deficient root and excessive superficiality, which are mainly caused by the deficiency of heart, liver, spleen, kidney as well as the dysfunction of viscera. Shi Zheng is caused by invasion and accumulation of wind, cold, damp and hot. The application of treatment includes the methods of dispelling wind and eliminating dampness, cooling blood and moistening dryness, discharging fire and detoxication, and tonifying deficiency or profiting loss. In the prevention of chronic urticaria, TCM emphasizes strengthening the healthy energy and regulating viscera to prevent recurrence. Combined with clinical practice, this article also discusses the common problems and puts forward some specific experience.