杨素清运用中医药治疗带状疱疹经验介绍

Experience of YANG Suqing Treating Herpes Zoster by Applying Chinese Medicine

带状疱疹是急性疱疹性病毒性皮肤病,严重影响患者健康及生活质量。杨素清教授依据皮损特点和发病过程,认为火、热、湿、毒、瘀是主要的致病因素,将其作为切入点进行分期论治。提出初期由火热妄动,外溢肌肤所致,以火热证多见,投以龙胆泻肝汤清热泻火;中期湿浊内生,流溢肌肤而发,常见于湿毒证,以胃苓汤以利水化湿;后期毒瘀走窜,漫溢肌肤而致,以毒瘀证为主,以桃红四物汤以解毒散瘀。各期随症加减,动态用药。杨素清教授认为疼痛是其治疗的关键所在,临床上常用香附、延胡索,桃仁、红花等止痛对药以行气活血;巧用忍冬藤、鸡血藤、夜交藤,全蝎、蜈蚣、地龙等藤虫类止痛角药以活血通络止痛,将治痛贯穿整个治疗过程。杨素清教授重视安神怡情,喜用柴胡、枳壳等疏肝理气;善用花类之凌霄花、玫瑰花等行气活血止痛;多用珍珠母、磁石等镇静安神。临床常配合火针、中药外涂等外治法,使内外结合,双管齐下,收效颇佳。

Herpes zoster is an acute herpetic viral skin disease,with great effects on the health and quality of life of patients. According to the characteristics of skin lesions and the pathogenesis,Prof. YANG Suqing believes that the fire,heat,dampness,toxin and stasis are the major pathogenic factors and takes them as the entry point for staged treatment. Prof. YANG Suqing suggests that the disease at the initial stage is caused by the frenetic stirring of fire and heat and the overflow of fire and heat on skin,and fireheat syndrome is mostly seen,which is treated with Longdan Xiegan Decoction to clear heat and purge fire;the disease at the middle stage is caused by the internal generation of damp-turbidity and the overflow of damp-turbidity on skin,and dampness toxin syndrome commonly occurs,which is treated with Weiling Decoction to induce diuresis and resolve dampness;the disease at the late stage is due to toxin and stasis going through the body and even overflowing the skin,and toxin stasis syndrome is mainly caused, which is treated with Taohong Siwu Decoction to detoxify and dissipate stasis. At each stage,modified prescriptions are given dynamically based on the symptoms. Prof. YANG holds that pain is the key for treatment. In clinical,common couplet medicinals for analgesia,including Cyperi Rhizoma,Corydalis Rhizoma,Persicae Semen and Carthami Flos,are used to move qi and invigorate blood;triple medicinals for analgesia in the categories of rattan medicines and worm medicines, including Lonice Raejaponicae caulis, Spatholobi Caulis, Caulis Polygoni Multiflori, Scorpio, Scolopendra and Pheretima, are flexibly applied to invigorate blood,free the collateral vessels and relieve pain,and the treatment for pain goes through the whole course. With a priority for calming the mind and lifting the spirit,Prof. YANG prefers to use Bupleuri Radix and Aurantii Fructus to sooth the liver and regulate qi;he does well in applying Campsis Flos, Rosae Rugosae Flos and other flower medicines to move qi and relieve pain;he usually adopts Margaritiferae Concha and Magnetitum for sedation and calming mind. In clinical, external treatments including fire needling and external application of Chinese medicine,are commonly combined to achieve a better therapeutic effect by adopting interior and exterior treatment simultaneously.