反复发作性寒湿型慢性湿疹验案1例

A case report on the treatment of recurrent chronic eczema with the syndrome of cold-damp

慢性湿疹是临床常见的炎症性皮肤病,西医治疗多采用糖皮质激素外用、抗组胺药口服等对症治疗,易产生药物依赖,存在病程长,易反复发作,迁延不愈的问题。传统中医认为湿疹与风、湿、热相关,治疗多从祛风、除湿、清热入手,但对于一些难治性慢性湿疹疗效不佳。仝小林院士认为,此案患者湿疹因胃肠表感受风寒湿邪气而发,邪气伏留中焦,郁而化热,遇风寒湿邪引动则病情加重,属于寒湿型慢性湿疹,可从脏腑风湿论治。治疗上予散邪透邪之法,以升阳散火汤加减治疗,收效明显。

Chronic eczema,a common infl ammatory skin disease in clinical practice,is often treated with topical glucocorticoids and oral antihistamines as a symptomatic treatment in western medicine,which tends to produce a drug dependence,giving rise to the problems of a long course,recurrent attacks and delays.Traditional Chinese medicine maintains that eczema is related to wind,dampness and heat,and treats it through dispelling wind,removing dampness and clearing heat,but it is not effective for some intractable chronic eczema.According to academician Tong Xiaolin,the eczema in this case is caused by wind,cold and dampness in the gastrointestinal tract,and the pathogens stay in the middle-jiao and turn into stagnation and heat.The disease aggravates when it is triggered by wind,cold and dampness again.So this case is recognized as chronic eczema with the syndrome of cold-damp,which should be treated based on the theory of zang-fu viscera rheumatism.The disease is treated by dispersing and penetrating the pathogens with modifi ed Shengyang Sanhuo Tang,which achieves a remarkable curative eff ect.