基于“形气神一体观”探讨斑秃的诊疗思路

Discussing The Diagnosis And Treatment of Alopecia Areata Based On“The Unity of Form,Qi And Spirit”

形气神一体观是中医整体观念的表现,也是中医独特地从物质形态、能量功能、精神思维三个层面探索人体的认知体系。斑秃作为临床常见的心身疾病,从形、气、神的视角出发,认为该病的发生与形质病变、气化失常、神志异常有关。“形质病变”是斑秃最突出的外在表现,脱发或被毛区的毛发损伤均可归于不同程度的“形变”,而该类“形变”的微观基础是玄府的病理变化,故“玄府形变”为斑秃发生的病理基础;“气化失常”是斑秃发生的中心环节,包括先后天脏腑虚衰和人体气机失常;神志异常古称“神不使”,贯穿于疾病的始终,是斑秃发生的关键因素。因此,斑秃的发生发展多由形、气、神三个层次的结构功能紊乱所致。本文从形气神一体观来诊疗斑秃,并依此提出急以固形、缓以治气、统以调神的治疗原则,以期为临床治疗斑秃提供又一新的思路。

The unity of form,qi and spirit is the embodiment of the holistic view of Chinese medicine and the unique cogni-tive system of Chinese medicine that explores the human body on three levels:material form,energy function and spiritual think-ing.As a common clinical disease of the mind and body,the occurrence of alopecia areata,from the perspective of form,qi and spirit,is related to morphological and qualitative pathologies,qi-chemical abnormalities,and abnormalities of the spirit.The most prominent external manifestation of alopecia areata is"morphological lesions".Hair loss or hair damage in the hair area can be attributed to different degrees of""morphological lesions",and the microscopic basis of these"morphological lesions"is the pathological manifestation of the Xuan Fu,so"Xuan Fu morphological lesions"are the basis for the occurrence of alopecia areata."Qi-transformation disorders"are the central link in the occurrence of alopecia areata,including the deficiency and failure of the internal organs and Qi disorders in the human body.The abnormality of the mind is known as"Shen bu Shi",and it is present throughout the disease.It is a key factor in the development of alopecia areata.Therefore,the development of alopecia areata is mostly due to the structural dysfunction of the three levels of form,qi and spirit.In this paper,we propose the treatment principles of restoring the shape in an urgent manner,treating the qi in a slow manner,and regulating the spirit in a unified manner,in or-der to provide new ideas for the clinical treatment of this disease.