张志礼治疗硬皮病临证经验

ZHANG Zhi-li’s experience in treating scleroderma

张志礼教授治疗自身免疫性皮肤病造诣颇高,在治疗硬皮病方面形成了独特的辨治体系。张志礼教授认为硬皮病的核心病机为脾肾阳虚,气血凝滞,治疗本病的主要法则为健脾益肾、活血化瘀。张志礼教授将本病辨证分为脾肺不足、脾肺肾俱虚两个证型。病情初期,皮损局限,证多属脾肺不足,以补益脾肺,温经通络,活血软坚为法治疗;病情后期,或呈现系统性损害,则证属脾肺肾俱虚,以健脾肺益肾、湿阳化水、活血软坚为法治疗。同时结合外治疗法可取得事半功倍之效。

Professor Zhang Zhi-li not only has many years of clinical experience in the treatment of autoimmune skin diseases, but also has formed a unique thought about differentiation and treatment system in the treatment of scleroderma. In his opinion, the principal pathogenesis of scleroderma are spleen-kidney Yang deficiency and stagnation of qi and blood. The main corresponding treatment methods are invigorating spleen and kidney as well as promoting blood circulation and removing blood stasis. Professor Zhang classified scleroderma as two types based on the syndrome differentiation, hypofunction of both spleen and lung, along with the deficiency of spleen lung and kidney. Hypofunction of both spleen and lung is the most common syndrome in the early stage of scleroderma, which is characterized by limited skin lesions. As a result, the main treatment methods include nourishing both lung and spleen, warming and activating meridian, activating blood and softening hard mass. In the later stage of the disease, often with systemic damage, the syndrome belongs to deficiency of spleen, lung and kidney, which should be treated by invigorating spleen, lung and kidney, warming Yang and diuretic, and activating blood and softening hard mass. At the same time, twice as much can be accomplished with half the effort by combining internal treatment with external therapy.