孙占学教授从郁火论治扁平苔藓经验

Professor Sun Zhanxue’s experience in the treatment of lichen planus from stagnant fire

扁平苔藓是一种以多角形紫红色扁平丘疹为皮损特点,易累及黏膜的慢性炎症性皮肤病。孙占学教授认为扁平苔藓的发病及其缠绵难愈的特点与郁火关系密切,临床上以解郁散火为治法,疗效确切。本文基于“诸邪壅塞,火郁三焦”“火郁日久,血瘀阴伤”“过用寒凉,壅遏伤正”的病机演变特点,结合经典与现代理论,系统阐述从郁火论治扁平苔藓。治疗方面,孙教授主张从“清上、畅中、泻下”三个层次以疏散三焦郁火,并强调用药时需兼顾采用凉润通补药以活血养阴,宜借辛味风药以开郁扶正,忌过用苦寒,同时注意根据病情特点辨证加减。

Lichen planus is a chronic inflammatory skin disease characterized by polygonal purplish red flat papules of skin damage and easily involving mucous membranes.Professor Sun Zhanxue believes that the occurrence of lichen planus and the characteristics of lingering and difficult to heal are closely related to stagnant fire.In clinic,relieving depression and dispelling fire is the treatment method with definite curative effect.Based on the pathogenesis evolution characteristics of“stagnant fire in sanjiao caused by stagnation of various evils”,“stagnant fire for a long time leads to blood stasis and yin injury”,“overuse of cold medicine will hinder the positive”,combined with classical and modern theories,this paper systematically expounds the treatment of lichen planus from stagnant fire.In terms of treatment,Professor Sun advocates evacuating the stagnant fire of sanjiao from the three levels of“cool the upper,smooth the middle,and purge the lower”,and stresses that the drugs with cold,moisturizing,purging and nourishing should be used to promote blood circulation and nourish yin,and the wind medicine with pungent flavor should be used to invigorate depression and to strengthen the body,and to avoid excessive use of bitter cold,at the same time,pay attention to syndrome differentiation according to the characteristics of the disease.