皮肤血络理论探析

Exploration of theory of cutaneous blood collaterals

络脉学说起源于《黄帝内经》,治法萌芽于《伤寒杂病论》,病证论治体系于《临证指南医案》初步形成,如今在许多学科中得到广泛应用。络脉学说在皮肤病领域的应用仍有待发展。皮肤络脉分为气络、津络、血络。血络主内守,气络主卫外,津络主充润。皮肤血络为皮肤腠理所属的有形络道,是脏腑病变传化到皮肤的必由之路。血络调和,则气络条达,津络畅通,皮肤络脉病变以皮肤血络为关键枢纽,也是皮肤病变的前提。邪气伏藏于皮肤血络,是慢性皮肤病的病机特点。笔者总结了络脉学说的渊源和现代发展,提出皮肤血络理论,并就其内涵、理论意义和临床价值进行了阐述,旨在推进络脉学说在皮肤病领域的应用。

Collateral theory originates from Huangdi Neijing(Huangdi’s Internal Classic).The corresponding therapeutic method originates from Shanghan Zabing Lun(Treatise on Cold Damage and Miscellaneous Diseases).And its pattern differentiation system is initially formed in Linzheng Zhinan Yi’an(Case Records as a Guide to Clinical Practice).The theory,widely adopted in various disciplines,still needs improvement in dermatology.According to the collateral theory,collaterals of the skin consist of qi collaterals,fluid collaterals and blood collaterals.Among them,the blood collaterals govern blood circulation in the vessels,the qi collaterals govern the defense against external pathogenic factors,and the fluid collaterals govern the filling and moistening of the skin and interstices.The cutaneous blood collaterals(vessels of the skin and interstices)play a critical role in the transmission of disease from internal organs to skin.The harmonious functioning of cutaneous blood collaterals will bring harmony to the other two types of collaterals.Otherwise,the cutaneous blood collaterals may become a necessary junction in the transmission and development of pathological changes in the cutaneous collaterals,which are also regarded as the precondition of skin diseases.Moreover,the mechanism of chronic skin diseases is also characterized by the latent pathogenic factors in cutaneous blood collaterals.This paper proposes the theory of cutaneous blood collaterals based on the origination and development of the collateral theory with an analysis of its connotation and significance in both theoretical and clinical aspects,which might provide insights into the application of collateral theory in the treatment of skin diseases.