李军教授从瘀毒论治线状扁平苔藓验案浅析

Analysis of Professor LI Jun s Experience in Treating Linear Lichen Planus from the Perspective of Stasis and Toxicity

线状扁平苔藓(linear lichen planus,LLP)为临床较少见的疾病,是扁平苔藓的亚型之一。病因病机为感受外邪、情志不畅、饮食不当、久病体虚,导致脾、肾功能减退,阴血亏虚,同时化生瘀血、浊毒,加之气机不畅,瘀毒蕴积肌肤腠理之间,形成病损瘙痒;临床治疗旨在调理气机,疏通肌膜,活血祛瘀,清热解毒以祛邪。李军教授总结LLP感受外邪、情志不畅、饮食不当、久病体虚等四大病因,从阴血不足、浊毒滞络的病机入手,以活血养血、利湿解毒为治法,并善用土茯苓、露蜂房等解毒除湿祛风药味,四诊合参且重视病证结合,祛邪同时注重顾护正气,从瘀毒的角度论治本病获得良效,丰富本病的中医诊疗思路。

Linear lichen planus is a rare clinical disease and one of the subtypes of lichen planus.The etiology and pathogenesis are the perception of external pathogens,poor mood,improper diet,prolonged illness and physical deficiency,leading to decreased spleen and kidney function,deficiency of Yin and blood,and the transformation of blood stasis and turbid toxins.In addition,poor Qi circulation results in the accumulation of blood stasis and toxins in the skin's striae,resulting in lesions and itching;Clinical treatment aims to regulate Qi,unblock muscle membranes,promote blood circulation and remove blood stasis,clear heat and detoxify to dispel pathogenic factors.Professor LI Jun summarized the four major causes of this disease,including external pathogenic factors,poor mood,improper diet,and prolonged physical deficiency.Starting from the pathogenesis of insufficient Yin and blood,turbid toxins and stagnation of collaterals,the treatment method is to promote blood circulation and nourish blood,promote diuresis and detoxification,and make good use of detoxifying,dehumidifying,and wind dispelling herbs such as Tufuling and Lufengfang.The four diagnostic methods are combined and the combination of disease and syndrome is emphasized.At the same time,attention is paid to the protection of normal Qi while eliminating pathogenic factors.From the perspective of stasis and toxin,the treatment of this disease has achieved good results,enriching the traditional Chinese medicine diagnosis and treatment ideas for this disease.