基于“诸痛痒疮,皆属于心”探讨从心论治外阴上皮非瘤样病变

Probe into the Treatment of Non-Neoplastic Lesions of the Vulvar Epithelium from the Heart Based on the Theory that"All Painful and Itching Sores Are Ascribed to the Heart"

刘完素认为,“诸痛痒疮,皆属于心”为“诸痛痒疮,皆属于心火”,强调心之病变易携火邪,且“火”为“痛、痒、疮”病变的主要病邪。外阴上皮非瘤样病变症状可总结为“淡、痒、痛、疮”,病机为血瘀、血虚、血热致血脉不盈,流行迟缓,病所失养,心神不安贯穿疾病始终。治疗应通心脉、养心血、泻心火、安心神。通心脉以血府逐瘀汤加减,养心血用归脾汤加减化裁,泻心火以清心泻火汤加减,安心神从养心安神和重镇安神两方面入手,因心血亏虚而致心神不安者应养心以安神,用养心汤;躁扰不安者应选用龙骨、牡蛎等重镇安神。治“心”使心之生理功能恢复,心神安定,则诸症可愈。

Liu Wansu believed that the theory that"All painful and itching sores are ascribed to the heart"means that"All painful and itching sores are ascribed to heart fire".He emphasized that heart-related disease is easy to be combined with fire pathogenic,and"fire"is the main reason for"pain,itch and scores".The symptoms of non-neoplastic lesions of the vulvar epithelium can be summarized as"bland,itch,pain,and sores".The pathogenesis is blood stasis,blood deficiency,and blood heat causing insufficient blood vessels,slow flow,loss of nourishment,and restlessness throughout the disease.The treatment should focus on unblocking the heart meridian,nourishing heart blood,relieving heart fire,and calming the mind.For unblocking the heart meridian,Modified Blood Mansion Stasis-Expelling Decoction can be used.For nourishing heart blood,Modified Spleen-Restoring Decoction can be used.For relieving heart fire,Modified Heart-Clearing and Fire-Purging Decoction can be used.For calming the mind,two aspects should be paid attention to:nourishing the mind and using heavy settling medicinal.Those who feel uneasy due to heart blood deficiency should nourish the mind to calm the mind,so Heart-Nourishing Decoction can be used.For those who feel restless,Longgu(Os Draconis),Muli(Concha Ostreae),etc.can be heavily used.Treating the"heart"can restore the physiological function of the heart,and stabilize the mind.Besides,psychological counseling in treatment can be emphasized to enhance the therapeutic effect.