黄褐斑中医辩证论治的思考

Thinking of TCM Dialectical Treatment of Chloasma

自《外科正宗》提出黧黑斑(黄褐斑)是由于"水亏不能制火,血弱不能华肉"的发病观点以来,历代传袭至今仍为单纯内因论。单纯内因论不能完全论述黄褐斑的成因和病机。正确理解"水亏不能制火"的深刻内涵,既包括肝肾精气不足,也包括属于火热之邪的日光及紫外线。外因通过内因起病理作用的发病模式,实际上已揭示了外因在黄褐斑发病的重要性。对黄褐斑(黧黑斑)的研究主要涉及黑色素细胞的生成和变化,深入全面掌握中西医有关黑素生成、代谢的基本规律,并尽可能科学地上升为中医理论,对于黄褐斑的现代中医治疗是有重要意义。

Since "WaikeZhengzong" puts forward the view that chloasmais due to the pathogenyof "water deficiency cannot control fire, blood is weak and cannot produce flesh", the inheritance of past generations is still purely internal.The theory of internal factors alone cannot fully discuss the causes and pathogenesis of chloasma.A correct understanding of the profound connotation of "water deficiency cannot make fire" includes not only insufficient liver and kidney essence, but also sunlight and ultraviolet rays, which are fiery evils.The pathogenesis of external factors through internal factors has actually revealed the importance of external factors in the onset of chloasma.The research on chloasma mainly involves the production and changes of melanocytes. A thorough and comprehensive mastering of the basic laws of melanogenesis and metabolism in Chinese and western medicine, and scientifically ascending to the theory of Chinese medicine, areof great significance for the treatment of chloasmaby modern TCM.