魏雅川主任论自身免疫性皮肤病中的痰瘀互结证病机

Discussion of Director Wei Yachuan on the Pathogenesis of Phlegm and Blood Stasis Syndrome in Autoimmune Skin Diseases

从痰瘀互结来论治疾病受到重视,关于自身免疫性皮肤病的痰瘀互结证病机也已有所认识。魏雅川主要从"肝肺气交"的角度来认识此类疾病的痰瘀互结证病机,如红斑狼疮的慢性过程提示,该病始于"肝肺气交"失调,"肝肺气交"失调可致"肝亢克脾"、"肺虚气滞",脾被肝克,运化不周,痰湿自生;肺气不足,帅行迟滞,血瘀自成;硬皮病的"痰"是外邪袭肺,与肺内精液裹挟而成的"恶痰",临床用药应直捣肺内"恶痰",兼以调节"肝肺",以使通过"肝肺气交"的运转生成更多的"正气";银屑病患者多为肝阴不足之体,待外邪扰动肺系,导致"肝肺气交"不顺、冲和不调时,从银屑病病变部位看,初病者以皮肤四末最明显,久病者四肢百骸皆可受累,变病者可因气血津液所变不同而出现不同的症状,如气血郁滞成瘀、津液不化成痰,气行妄动成风等,所以临床所见除有主症外多有夹杂症,痰瘀互结之致症状亦在其中。

It has been paid attention to treat diseases by combining phlegm and blood stasis,and the pathogenesis of the syndrome of combining phlegm and blood stasis in autoimmune skin diseases has also been recognized.Wei Yachuan mainly understands the pathogenesis of this kind of disease from the perspective of"liver lung qi exchange".For example,the chronic process of lupus erythematosus suggests that the disease starts from the imbalance of"liver lung qi exchange",which can lead to"liver hyperactivity and spleen","lung deficiency and qi stagnation",the spleen is blocked by the liver,the circulation is not complete,and the phlegm and dampness are self generated;the deficiency of lung qi,the delay of handsome movement,and the blood stasis are self generated;the pathogenesis of scleroderma.Phlegm is a kind of"evil phlegm"which is formed by external evil attacking the lung and entrapped with the semen in the lung.In clinical medicine,it is necessary to directly pound the"evil phlegm"in the lung and regulate the"liver and lung"so as to generate more"positive qi"through the operation of"liver lung air interaction".Patients with psoriasis are mostly lack of liver yin.When the external evil disturbs the lung system and causes the"liver lung air interaction"to be not smooth,flushed and not regulated,the lesions of psoriasis should be taken into consideration.It can be seen that the skin of the first patients is the most obvious at the end of the fourth period,and all the limbs of the long-term patients can be affected.The patients who become sick can have different symptoms due to the different changes of qi and blood body fluid,such as stagnation of qi and blood into stasis,body fluid does not turn into phlegm,and excessive qi movement into wind.Therefore,in addition to the main clinical symptoms,there are many miscellaneous diseases,and the symptoms caused by the combination of phlegm and blood stasis are also included.