仝小林应用桑白皮、地骨皮、白鲜皮治疗老年皮肤瘙痒症经验

Tong Xiaolin's experience in the treatment of senile pruritus with white mulberry root-bark,Chinese wolfberry root-bark and densefruit pittany root-bark

仝小林院士认为老年皮肤瘙痒症发病往往由于老年阴分不足,郁生内热,煎灼上焦发为肺热,并生温燥扰动皮毛。临床常在滋阴润燥的基础上,加用桑白皮、地骨皮、白鲜皮组成的三皮止痒方清热养阴止痒。方中桑白皮清泻肺热,善治浮风燥痒;地骨皮常与桑白皮同用,滋阴降火解决老年患者阴虚体态,且平肺气、除郁热,使肺热宣泄而皮毛开;白鲜皮清热燥湿、祛风解毒,为治皮肤瘙痒之靶药。三者配伍,态靶结合,既合老年皮肤瘙痒症的病机特点,又能针对性减轻患者瘙痒症状,临床常用剂量均为15~30 g。

Professor Tong Xiaolin believes that senile pruritus is often caused by the insufficient yin phase in the elderly,resulting in depression generating internal heat,which in turn burns and scorches the upper jiao to cause lung heat,leading to warm dryness disturbing the skin.In clinical practice,on the basis of nourishing yin and moistening dryness,he uses the Sanpi Zhiyang Formula to clear heat,nourish yin,and relieve itching,which is composed of white mulberry root-bark,Chinese wolfberry root-bark and densefruit pittany root-bark.In the formula,white mulberry root-bark has the effect of clearing lung heat,good at treating floating wind,dryness,and itching,while Chinese wolfberry root-bark is often used in conjunction with white mulberry root-bark to nourish yin and reduce fire,solving the problem of yin deficiency state in elderly patients,and calming the lung qi,removing depression and heat,so that the lung heat is vented and the skin is opened,and densefruit pittany root-bark is good at clearing heat and dampness,dispelling wind and detoxification,acting as the target medicine for treating pruritus.The combination of the three herbs means to deal with both the state and the target of the disease,not only conforming to the pathogenesis characteristics of senile pruritus,but also effectively alleviating the itching symptom.The commonly used clinical dosages of these three herbs are all 15-30 g.