从温阳透发法论治难治性痤疮

Treatment of Refractory Acne with Wen Yang Tou Fa Method

痤疮可辨为阴、阳两证。阳疮者,缘患者劳汗被寒、玄府闭合,汗脂凝聚日久不得外排,蕴热搏结气血而生疮化腐,疮症为热为痛,此为易治;阴疮者,由阳疮转化而来,缘患者外感寒风、内伤生冷,且医者又重用寒凉、失于托透,以至气血冰凝,久不溃脓或溃脓难出,此为难治。根据难治性痤疮临床表现,其多类属于阴疮,以阳虚表郁、邪闭毛窍为致病之关键,其中表郁毛窍、邪闭肌腠为病之标,阳虚阴凝为病之本。治疗当以温阳透发、祛邪外达为法。以麻黄附子细辛汤温阳化阴滞、发阳透毒治其本,待阴邪发越,即用火针强开门户、消疮排脓治其标。标本兼治、针药结合的方法治疗难治性痤疮在临床中能够安全有效地消除痤疮、改善皮损、降低复发率。

Acne can be distinguished as Yin or Yang Syndrome. For those with Yang sores,the patient’ s sweat is closed by the cold. The sweat sebum can’t be discharged for a long time. The heat can block the Qi and Blood,and the sore can turn into rot. The sore is heated and painful,which is easy to cure. Yin acne is transformed from the Yang case. The patient suffers from cold wind and internal injuries,and the doctor overuses cold drugs,which lead to the blood coagulation. It is difficult to treat if the pus is not ulcerated or festering for a long time. According to the clinical manifestations of refractory acne,many of them belong to Yin acne,and the key factor of the disease is Yang deficiency and Qi depression at skin,which is the inner cause and the surface cause,respectively. Treatment of the disease should be n warming Yang to dispel Evil factor out. Mahuang fuzi Xixin Decoction is used in this case. When the Yin evil is forced to the skin layer,the fire needle acupuncture is used to open the portal and eliminate sores and pus. Treating refractory acne with a combination of symptoms and acupuncture can safely and effectively eliminate acne,improve skin lesions,and reduce the recurrence rate in the clinic.