象思维视域下论治雄激素性脱发

Treatment of androgenetic alopecia from the perspective of image thinking

中医象思维是一种通过“象”之间的相通相应点来建立对应联系的思维方式,是用自然界已知的物质属性、规律及性质来探索、推理中医药本质规律的思维方法。文章立足于传统的象思维模式,将头发比类为草木,并结合对雄激素性脱发的现代认识,概括其病机内涵。以草木因水源干涸无以滋养而凋,类比肾精匮乏,血不化精,致毛窍空虚,毛发枯槁而堕;以草木因水涝日久浸泡过度而亡,类比湿热上蒸巅顶,浸淫发根,发根不固而脱;或以草木因土壤硬化板结、透气性差而无法生长,类比血瘀毛窍,经气不宣,发根失濡而脱发。治疗上,以自然界草木的治理,类比雄激素性脱发的诊治。以草木需施肥灌水,类比需滋肾固本以养阴生发;以草木需利水排涝,类比宜化浊降脂以牢固发根;以草木需疏松土壤,类比宜化瘀通络以改善毛囊血供。同时,新生的头发犹如草木之幼芽嫩苗,应注意调护。本文以象思维论治雄激素性脱发,以期为临床治疗雄激素性脱发提供又一思路。

Image thinking in traditional Chinese medicine(TCM)is a way of thinking to establish connections with corresponding“images”and to explore the links between the essential laws of TCM and the material attributes,laws,and properties known in nature.Based on traditional image thinking,we compare hair to trees and combine TCM with the modern understanding of androgenetic alopecia to describe its pathogenesis.It is believed that plants and trees wither in dry conditions.This is similar to a lack of kidney essence;when blood can’t be transformed into essence,resulting in damage to emptiness of hair follicles,hair shrivels and falls off.Similarly,plants and trees can die due to excessive water over a long period of time,which is analogous to steaming on the parietal bone due to dampness-heat;the hair root is soaked,becomes soft,and dies.In other cases,because of soil hardening and poor permeability,the root cannot grow,which is analogous to blood stasis in the hair follicle;the flow of qi in the meridians is not smooth and the hair roots are not moistened,resulting in hair loss.The treatment of androgenic alopecia is therefore analogous to the treatment of natural plants and trees.Plants and trees need to be fertilized and irrigated;in analogy,the kidney should be nourished to secure the root so as to replenish yin and grow hair. Plants and trees need water drainage;similarly, turbidity and the fat should betransformed and reduced to strengthen the roots. Plants and trees need loose soil;in analogy, in thescalp, blood stasis should be removed to improve the blood supply of hair follicles. Furthermore, newhairs are like seedlings;therefore, we should pay attention to disease aftercare. This article discusses thetreatment of androgenic alopecia based on image thinking in order to provide a new perspective for theclinical treatment of androgenic alopecia.