基于“湿热生虫”理论探析疮证治

Analysis on syndrome differentiation and treatment of palmoplantar pustulosis based on the theory of“damp heat producing insects”

瘑疮是一种较为常见的中医外科疾病,常见瘙痒、渗出以及脱屑等临床表现。该病极其顽缠,病情迁延,可对患者日常生活产生较大影响。中国古代对瘑疮的记载最早可追溯到甲骨文时期。古代医家对于瘑疮的临床表现及治疗方法论述颇详,但对其证治分型却鲜有记载。“湿热生虫”是中医特色理论之一,是对病因病机的高度概括。笔者通过对中医文献的研究,认为瘑疮为病,当主责于“湿热生虫”。在中医“湿热生虫”理论的基础上,笔者又将该病分为虫邪在表、虫在肌肉、虫入血分及虫毒日久四型,并分别对每一分型的临床表现及治法方药进行总结,以期为瘑疮临床诊治提供新的思路及方法。

Palmoplantar pustulosis is a common surgical disease of traditional Chinese medicine,common itching,exudation and desquamation and other clinical manifestations.The disease is extremely persistent and protracted,which can have a great impact on the daily life of patients.In ancient China,the earliest records of palmoplantar pustulosis can be traced back to Oracle Bone Inscription Dynasty.The ancient doctors discuss the clinical manifestations and treatment methods of palmoplantar pustulosis in detail,but there are few records on its syndrome differentiation and treatment.“Damp heat producing insects”is one of the characteristic theories of traditional Chinese medicine,which is a high generalization of etiology and pathogenesis.The author thinks that the main responsibility of the disease is“damp heat producing insects”based on the research of traditional Chinese medicine literature.On the basis of the theory of“damp heat producing insects”in traditional Chinese medicine,the disease can be divided into four types:insect pathogen in the surface,insect in the muscle,insect in the blood and insect toxin for a long time.And the author summarizes clinical manifestations and therapeutic prescriptions of each type respectively,in order to provide new ideas and methods for the clinical diagnosis and treatment of palmoplantar pustulosis.