脂溢性脱发中医诊治源流探析

Analysis on the origin of TCM diagnosis and treatment of seborrheic alopecia

本文通过查阅古今医籍,从病名、病因病机、治疗、预防调护四方面梳理探析古今医家对脂溢性脱发的不同认识,进一步呈现本病的诊治进程。各时期病名繁多,统一于明清提出的“发蛀脱发”“蛀发癣”之名;病因虚实夹杂,本虚多责于肾虚、血虚,标实则以湿热、血瘀、血热为要;治疗上内外同治,内治上辨证治疗,实则泻之、虚则补之,外治上针刺叩击以通经活络,洗剂、膏剂、散剂等多种剂型外用以直达病所;预防调护也日趋被重视,从而干预发病、缩短病程、改善预后。

By consulting ancient and modern medical books,the different understandings of ancient and modern doctors on seborrheic alopecia from the four aspects of disease name,etiology and pathogenesis,treatment,prevention and care were analyzed,and further presents the diagnosis and treatment process of this disease.There are many disease names in each period,the names of“hair moth and alopecia”and“tinea worm”was unified in the Ming and Qing dynasties.The causes of deficiency and excess are mixed,the original deficiency is mostly responsible for kidney deficiency and blood deficiency,and the actual signs are damp-heat and blood stasis and blood heat.In treatment of internal and external treatment,internal is treatment based on syndrome differentiation,“actually relieves it”“deficiency is replenishment”,external treatment is treated by acupuncture and percussion to clear the meridian,a variety of dosage forms such as lotion,ointments and powders are used externally to reach the disease site.And prevention and care were also increasingly valued,so as to intervene in the onset,shorten the course of the disease,and improve the prognosis.