寻常型银屑病病因病机探讨

Discussion on the etiology and pathogenesis of psoriasis vulgaris

通过复习历代医家对干癣、白疕等银屑病类似病的认识,认为"血热、血燥、血瘀"三证(经典方案)的提出是对银屑病辨证治疗的继承和创新,但也存在辨证思维局限,难以客观、全面揭示银屑病病因病机的欠缺。本文根据《内经》"天人相应"理论,结合临床实际和现代研究,基于"天-地-人"的整体辨证思维和"治病求本"思想,对银屑病的病因病机进行了客观、深入探讨,指出寒冷是银屑病发生发展的重要因素,阐述了银屑病"冬重夏轻"规律的机制。并就所归纳提出的银屑病辨治"新方案"和"经典方案"进行了充分的讨论。认为"新方案"的辨证思维既有广度,又有深度,归纳总结的证治方案较之"经典方案"更加客观、实用,值得验证推广。

Based on a review of the understanding of psoriasis-like diseases such as ganxian(干癣, chronic eczema) and baibi(白疕, psoriasis) by generations of TCM physicians, it is believed that the proposal of the three patterns of "blood heat, blood dryness, and blood stasis" in the classic treatment plan was great inheritance and innovation of pattern differentiation and treatment of psoriasis. However, there were still limitations in ideas of pattern differentiation, which made it difficult to objectively and comprehensively reveal the etiology and pathogenesis of psoriasis. In accordance with the theory of correspondence between human beings and nature in Neijing(Internal Classic), incorporating clinical practice and modern research, and based on the holistic "heaven-earth-man" pattern differentiation and the idea of "seeking the root to treat the disease", the present research discussed the etiology and pathogenesis of psoriasis in an objective and in-depth manner. It was pointed out that cold was an important factor in the occurrence and development of psoriasis. The reason for and mechanism of the fact that psoriasis is often severe in winter and mild in summer were explained. In addition, both the proposed "new plan" and "classic plan" for pattern differentiation and treatment of psoriasis were discussed thoroughly. It is believed that the new plan enjoys both breadth and depth in its ideas of pattern differentiation, is more objective and practical than the classic plan, and warrants validation and promotion.