卢益萍教授辨治寻常型银屑病用药经验与规律研究

Professor LU Yiping's experience and medication law in differentiating and treating psoriasis vulgaris

目的:基于古今医案云平台分析卢益萍教授治疗寻常型银屑病的用药规律。方法:收集2022年9月1日―2023年3月1日卢益萍教授所治疗的寻常型银屑病患者的中药处方,对处方进行归纳整理后得到75首有效处方,并将其录入到古今医案云平台中,经标准化处理后,建立数据库,并进行数据挖掘分析,明确卢益萍教授治疗寻常型银屑病的诊疗思路。结果:所收集的75首处方中,涉及药物50种,其中使用频次超过60次的药物有13味,多为清热解毒、清热凉血类药;用药以寒、平两性为主;味多为甘、苦、辛;药物主归肝、心、肺、脾经;所用药物功效以清热解毒、清热凉血为主;关联分析显示常见配伍为丹参-生地黄,二者合用更能养阴活血,祛瘀润肤;复杂网络分析中得到卢益萍教授治疗寻常型银屑病的核心处方为半枝莲、白花蛇舌草、土茯苓、牡丹皮、生地黄、丹参、槐花、紫草、白茅根、山豆根、防风、乌梅、云芝、甘草。该方药重以清热凉血解毒,透疹消疮,卢教授将此方随证加减应用于临床。结论:该研究从用药、性味、归经、功效主治上进行分析后得出卢益萍在治疗寻常型银屑病时紧扣从血论治这一原则,自拟白疕1号14味以清热解毒凉血消斑为主,并在临床治疗中随证化裁,提高临床疗效。

Objective:To analyze the medication law of Professor LU Yiping in the treatment of psoriasis vulgaris based on the cloud platform of ancient and modern medical records.Methods:The traditional Chinese medicine prescriptions for patients with psoriasis vulgaris from Professor LU Yiping from September 1,2022 to March 1,2023 were collected,and 75 effective prescriptions were obtained after summarizing and organizing the prescriptions,which were recorded into the cloud platform of ancient and modern medical records.After standardized processing,a database was established and data mining analysis was conducted to clarify Professor LU Yiping's diagnosis and treatment ideas for psoriasis.Results:Out of the 75 prescriptions collected,50 drugs were involved,of which 13 drugs were used more than 60 times,mostly for clearing heat and detoxifying,and clearing heat and cooling blood;The medication was mainly cold and mild in property;The flavor was mostly sweet,bitter,and spicy;The drugs mainly returned to the liver,heart,lung,and spleen meridians;The main effects of the drugs used were clearing heat and detoxifying,and clearing heat and cooling blood;Correlation analysis showed that the common compatibility was Danshen(Radix et Rhizoma Salviae Miltiorrhizae)-Dihuang(Radix Rehmanniae).The combination of the two can nourish Yin(阴),promote blood circulation,remove blood stasis,and moisturize the skin;According to the complex network analysis,Professor LU Yiping's core prescription for the treatment of psoriasis vulgaris was Banzhilian(Scutellaria barbata),Baihuasheshecao(Scleromitrion diffusum),Tufuling(Smilax glabra),Mudanpi(Peony bark),Shengdihuang,Danshen,Huaihua(Sophora japonica),Zicao(Lithospermum),Baimaogen(Festuca pekinensis root),Shandougen(Croton root),Fangfeng(Saposhnikovia divaricata),Wumei(Mume),Yunzhi(Coriolus versicolor),and Gancao(Glycyrrhiza uralensis).This prescription was mainly used to clear heat,cool blood,detoxify,and eliminate rashes and ulcers.Professor LU had applied this formula to clinical practice based on the changes of symptoms.Conclusion:After analyzing the medication,property and flavor,meridian tropism,and efficacy indications in this study,it is concluded that LU Yiping closely adheres to the principle of treating psoriasis vulgaris based on blood.The Professor has developed a self-formulated Baibi No.1 Formula(白疕1号),which is of 14 medicinals to clear heat,detoxify,cool blood,and eliminate spots,and it is adjusted according to clinical symptoms to improve clinical treatment effectiveness.