赵学义运用地膏麻附细辛汤治疗血热证寻常型银屑病经验

ZHAO Xueyi’s experience in applying Digao Mafu Xixin decoction in treating psoriasis vulgaris of blood-heat syndrome

寻常型银屑病是一种常见于当今和国内外临床的皮肤科疾病,为具有代表性的难治性疾病之一,也是一种遗传与环境因素共同作用诱发的免疫介导的慢性、复发性、炎症性、系统性疾病,典型临床表现为鳞屑性红斑或斑块,局限或广泛分布,无传染性,治疗困难,常罹患终身,是皮肤科较常见的炎症性疾病,与皮肤免疫系统等都存在着复杂而密切的组织病理关系,其发病的根本机制仍不是很清楚。如今我国在西医治疗方面仍然缺乏先进有效的诊疗新方法,所以银屑病的发病机制及相关治疗仍是目前亟待解决的问题。历代中医医家对银屑病病因病机学说多为从“血热”“血瘀”“血燥”三方面分析,认为血热是导致银屑病发作的主要原因之一,故中医多采取清热凉血之法治疗该病。文章经探索血热证寻常型银屑病的病因病机,通过临床医案的形式从病因病机、临证验方及配伍加减探讨赵学义主任灵活运用地膏麻附细辛汤加减治疗血热证寻常型银屑病的临床有效性、安全性和对病情复发的控制情况,以期为临床应用提供证据,为现代中医学治疗血热证寻常型银屑病提供很好的研究,从而达到疗效显著的优势,为中医防治银屑病提供思路与方法。

Psoriasis vulgaris is a common disease in clinical dermatology at home and abroad and one of the representative refractory diseases.It is also an immune-mediated chronic,recurrent,inflammatory and systemic disease induced by the combined effects of genetics and environment mediated immunity.The typical clinical manifestations are squamous erythema or plaques,limited or widely distributed.It is non-infectious and difficult to treat,which is often lifelong.It is a common inflammatory disease in dermatology,which has a complex and close histopathological relationship with the skin immune system,etc.,and the fundamental mechanism of its pathogenesis is still not clear.At present,there is still a lack of advanced and effective new diagnosis and treatment methods in Western medicine,so the pathogenesis and related treatment of psoriasis vulgaris are still urgent problems to be solved.Traditional Chinese medicine doctors in the past dynasties analyzed the etiology and pathogenesis of psoriasis vulgaris from three aspects:“blood heat”,“blood stasis”and“blood dryness”,they believed that blood heat is one of the main causes of psoriasis vulgaris,so traditional Chinese medicine mostly applied the method of clearing heat and cooling blood to treat the disease.This paper explores the etiology and pathogenesis of psoriasis vulgaris with blood-heat syndrome,and discusses the clinical effectiveness,safety and control of disease recurrence of psoriasis vulgaris with Director ZHAO Xueyi’s flexible application of Digao Mafu Xixin decoction(地膏麻附细辛汤)in the form of clinical medical records from the perspectives of etiology and pathogenesis,clinical evidence and compatibility.It can provide evidence for clinical application,and provide a good study for modern traditional Chinese medicine to treat psoriasis vulgaris with blood heat syndrome,thus achieving significant curative advantages,and providing ideas and methods for TCM prevention and treatment of psoriasis vulgaris.