运用解毒安络法内外合治多形性日光疹

Treatment of Polymorphic Light Eruption Using Resolving Toxins and Tranquilizing Collaterals Method

皮部络脉(简称“皮络”)是皮肤腠理间气血津液输布的通道,又是病邪入侵的路径。认为多形性日光疹以毒损皮络为病机关键,其中皮络失养、肌表不固为发病基础,邪犯气络、郁热酿毒为始动因素,渐及津络、燥湿并存为中间环节,毒伏血络、伺机而发为终末阶段。提出以解毒安络为基本治法,内外合治。内治以解络毒、夯络虚、助络通,自拟五藤饮合异功散为基本方加减,促进毒邪排出,加强皮络御邪之力。外治根据皮损表现选择刮痧、溻渍、软膏以驱邪解毒、疏达皮络,早期皮温升高、瘙痒、刺痛而未见皮疹,可选用自拟银黄草清解油刮痧以活血调气、透热排毒;若皮损红斑、丘疹、瘙痒,可选用自拟千艾熏洗方溻渍以宣通气液、通络涤毒;若皮损肥厚伴鳞屑,可选用自拟愈肤膏外搽以解毒活络、润肤敛疮。

Collateral vessels in cutaneous regions are the channel of qi,blood and body fluids transmission among the skin and striae and interstices,and is also the path of pathogens invasion.It is believed that the key pathogenesis of polymorphic light eruption(PLE)was toxins damaging to the skin,in which the cutaneous collaterals fail to nourish,insecurity of the muscle surface as the basis of disease,the pathogens offending qi collaterals and heat constraint to toxins as the driving factors,gradually affecting fluid collaterals and dryness-dampness coexist as the middle link,and latent pathogens in blood level and waiting for the opportunity to onset as the final stage.It is proposed that the basic treatment is to resolve toxins and tranquilize collaterals,and the internal and external treatments are combined together.The internal treatment is to resolve toxins,strengthen collaterals,and assist in unblocking the collaterals,and the modified self-prescribed Wuteng Decoction(五藤饮)plus Yigong Powder(异功散)were selected as the basic formulas,which promotes the discharge of toxin pathogens and strengthens the power of the cutaneous collaterals to protect against pathogens.For external treatment,according to the performance of skin lesions,scraping,tapping with medicinal solution,ointment were selected to drive away pathogens and resolve toxins,and soothe the cutaneous collaterals.In the early stage,the skin temperature rose with itching,tingling and no rash,scraping with the self-prescribed Yinhuangcao Clearing Oil(银黄草清解油)could be used to activate blood and regulate qi,relieve heat and resolve toxins;if the lesions showed erythema,pimples,itching,tapping with the self-prescribed Qian'ai Xunxi Formula(千艾熏洗方)could be used to diffuse qi and fluid,unblock the collaterals and clean toxins;if the skin lesions thickened with scales,the self-prescribed Yufu Ointment(愈肤膏)for external application could be used to resolve toxins and activate collaterals,moisten skin and heal up sore.