赵坤应用三焦理论辨治带状疱疹经验

Zhao Kun′s Experience of Treating Herpes Zoster with the Theory of Triple Energizer

赵坤依据带状疱疹病因、病机、发病部位及临床表现,应用三焦理论进行辨治。邪犯上焦,多见于疾病早期,为风热毒邪上犯上焦所致,治以疏风散邪解毒,方选普济消毒饮加减。邪犯中焦,多由肝经湿热火毒瘀滞所致,治以清肝利湿、凉血解毒,方用龙胆泻肝汤合五味消毒饮汤,此阶段,由于局部症状明显,疼痛剧烈,赵老师另给予雄黄、冰片、黄柏、利多卡因乳膏调成糊状,涂于患处。邪壅下焦,多见于疾病后期,由中焦湿热火毒证余毒未清,瘀血等邪气阻滞于经络而致,治以活血化瘀、行气止痛,方选桃红四物汤加减。急性期强调清热解毒、利湿止痛之法,后期注重益气散血、搜风通络之功,活血化瘀贯穿整个病程。

For herpes zoster(HZ),Zhao Kun applies the theory of triple energizer to treat it according to its etiology, pathogenesis, location and clinical manifestations.The pathogen attacking the upper energizer is mostly seen in the early stage of the disease, which is caused by the wind-heat toxin.The treatment should focus on removing wind and dispelling pathogens and removing toxin.Modified Universal Relief Toxin-Removing Beverage can be adopted.The pathogen attacking the middle energizer is mostly caused by the stagnation of dampness-heat, fire toxin and blood stasis in the liver meridian.The treatment should focus on clearing the liver and removing dampness, cooling blood and relieving toxins.Gentian Liver-Draining Decoction combined with Five Ingredients Toxin-Removing Beverage can be adopted.At this stage, due to obvious local symptoms and severe pain, Professor Zhao also uses paste made from Xionghuang(Realgar),Bingpian(Borneolum Syntheticum),Huangbai(Cortex Phellodendri Chinensis) and lidocaine cream to apply to the affected part.The pathogen stagnates in the lower energizer, which is mostly seen in the late stage of the disease.It is caused by the residual toxin of the dampness-heat toxin syndrome of the middle energizer, and the blood stasis and other pathogenic qi blocking the meridians.The treatment focuses on promoting blood circulation to remove blood stasis, moving qi movement to relieve pain.Modified Peach Kernel and Carthamus Four Substances Decoction can be adopted.In the acute stage, she emphasizes the methods of clearing heat, relieving toxins, removing dampness and arresting pain.In the later stage, she pays attention to the functions of replenishing qi and dispersing blood, removing wind and dredging collaterals, promoting blood circulation and removing blood stasis throughout the whole course of the disease.