眭道顺从“少阳为枢”论治胆碱能性荨麻疹

SUI Dao-Shun’s Experience in Treating Cholinergic Urticaria Based on“Shaoyang As the Pivot”Theory

“少阳为枢”是中医学理论中的重要概念之一。少阳位于半表半里间,外达肌表,内联脏腑,能够发挥畅气机、调水道、游相火的功能;少阳枢机失调可致气机紊乱、水液代谢失常、相火郁结妄动等。胆碱能性荨麻疹是一种由于胆碱能神经传导障碍而导致的特殊类型的荨麻疹,其病程长,难以治愈。眭道顺教授根据该病的临床特征,认为少阳枢机不利是其核心病机。情志不畅而致枢机不畅,导致气津疏泄失常、相火妄动内扰,致使营卫不和无力抗邪,风邪外袭隐于皮肤腠理而发为胆碱能性荨麻疹。治疗时可采用柴胡桂枝汤为基本方以和解少阳、透邪解表,临证运用可根据少阳枢机不利所致的气滞、湿停、郁热等不同病证而酌加相应药物。基于“少阳为枢”防治胆碱能性荨麻疹,可为该病的临床治疗提供思路。

“Shaoyang as the pivot”is one of the important concepts in the theory of traditional Chinese medicine.It is believed that shaoyang is located between half exterior and half interior,which reaches the muscular striae and the exterior and connects with the internal organs,and plays the role of promoting qi movement,regulating water channel and distributing ministerial fire.The dysfunction of shaoyang pivot leads to the disorder of qi movement,abnormal water metabolism,and stagnation or hyperactivity of ministerial fire.Cholinergic urticaria is a special type of urticaria caused by the disorder of cholinergic nerve conduction,which has a long course of disease and is difficult to be cured.According to the clinical characteristics of the disease,Professor SUI Dao-Shun believes that the dysfunction of shaoyang pivot is the core pathogenesis of cholinergic urticaria.Emotional disorders lead to the dysfunction of pivot,and then cause the disordered flow of qi and fluid and internal disturbance of hyperactive ministerial fire,which induce the disharmony between nutritive qi and defensive qi,and the failure of being against the pathogens.Finally,wind pathogen attacks the skin and muscular striae and becomes latent,and results in cholinergic urticaria.For the treatment of cholinergic urticaria,Chaihu Guizhi Decoction can be used as the basic prescription to harmonize shaoyang,expel pathogens and release exterior.Corresponding modification of herbal medicines should be performed for various syndromes caused by the dysfunction of shaoyang pivot such as qi stagnation,dampness retention and heat stagnation during the clinical application.The prevention and treatment of cholinergic urticaria based on the theory of shaoyang as the pivot can provide thoughts for the clinical treatment of cholinergic urticaria.