基于相火理论辨治雄激素性脱发

Clinical application of ministerial fire theory in differentiation treatment of androgenetic alopecia

雄激素性脱发(androgenetic alopecia, AGA)是最常见的脱发类型,中医学称其为“发蛀脱发”“蛀发癣”。相火理论是中医学的特色理论之一,对临床诊治疾病有重要的指导意义。生理性相火是维持人体生命活动的原动力,相火妄动即病理性相火,是导致疾病的贼邪,其成因主要为脏腑之火相煽、情志失调。AGA根本病机为相火妄动,主要表现在:情志过极,相火亢盛;劳欲不节,相火离位;禀赋异常,相火易亢。基于相火理论治疗AGA,包括:养心正志,相火自安;安宁君火,清降相火;滋阴固本,补水泻火;阴阳双补,引火归元。本文结合临床验案阐述基于相火理论对AGA的辨治。

Androgenetic alopecia(AGA)is the most common type of hair loss.In traditional Chinese medicine(TCM),it is referred to as fazhu tuofa(hair loss due to hair damage)or zhufaxuan(hairdamaging tinea).The ministerial fire theory is one of TCM’s distinctive theories,providing significant guidance for clinical diagnosis and treatment.Physiological ministerial fire is the driving force that sustains life activities,while pathological ministerial fire,characterized by its hyperactivity,is a pathogenic factor.The primary causes of this condition include the excessive fire in the internal organs and emotional imbalance.The fundamental pathogenesis of AGA is hyperactivity of ministerial fire,which mainly manifests as:excessive emotions leading to overactivity of ministerial fire;unregulated labor and desire causing dislocation of ministerial fire;and abnormal endowment making ministerial fire prone to hyperactivity.Treatment of AGA based on the ministerial fire theory includes:nourishing the heart and regulating emotions;calming the heart-fire and subduing ministerial fire;nourishing yin and strengthening the root,replenishing water and purging fire;balancing yin and yang,guiding the fire to return to its source.This paper combines clinical cases to elucidate the diagnosis and treatment of AGA based on the ministerial fire theory.