陈明岭教授辨治慢性荨麻疹经验

Professor Chen Mingling's experience in the diagnosis and treatment of chronic urticaria

慢性荨麻疹是一种难以治愈的变态反应性皮肤病,以反复发作的风团为主要表现,常伴瘙痒,病程长;其发病机制复杂且尚不明确;目前西医治疗本病主要以二代抗组胺药为一线用药,短期效果明显,长期疗效不尽如人意,并且长期使用抗组胺药存在一定副作用及耐药情况;基于对本病病机的多样性的认识,中医治疗本病灵活多样,有中药内服、中医外治、中西医结合治疗等手段。本文主要介绍吾师陈明岭教授治疗慢性荨麻疹的经验,吾师以为地域对人的体质有着重要的影响,而个人体质又决定者疾病的病机特点及转归;川渝地区气候湿热,故其民易感湿邪,陈教授总结多年的临床经验认为川渝地区慢性荨麻疹的主要病机应为风湿热郁于肌肤腠理,内失于疏泄,外疏失于透达,邪正交争而发病。临证多从“风”“湿”“热”“寒”“虚”五个角度出发,以简化消风散为基础方加减化裁,综合治疗,每获良效,值得推广。

Chronic urticaria is a kind of allergic skin disease which is difficult to cure.The main manifestation of chronic urticaria is recurrent rheumatic mass,which is often accompanied with itching and a long course of disease.Its pathogenesis is complex and unclear.At present,the second generation antihistamines are the first-line drugs in the treatment of this disease.The short-term effect is obvious and the long-term effect is unsatisfactory.There are some side effects and drug resistance in the long-term use of antihistamines.Based on the understanding of the diversity of the pathogenesis of this disease,TCM treatment of this disease is flexible and diverse,including oral administration of traditional Chinese medicine,external treatment of traditional Chinese medicine,integrated treatment of traditional Chinese and Western medicine and other means.This article mainly introduces Professor Chen Mingling's experience in treating chronic urticaria.Professor Chen holds that the region has an important influence on people's physique,and the individual physique determines the pathogenesis,characteristics and outcome of the disease.Professor Chen concludes that the main pathogenesis of chronic urticaria in Sichuan-Chongqing area should be rheumatism-heat depression in skin,internal loss in catharsis,external neglect in penetration,and orthogonal disputes between pathogens.From the five perspectives of“wind”,“dampness”,“heat”,“cold”and“deficiency”,synthetical treatment based on simplified Xiaofeng powder(简化消风散)is worth popularizing.