从肝肾内外合治外阴白色病变经验

Experience in Combined Internal and External Treatment of White Lesion of Vulva from Liver and Kidney

认为外阴白色病变的核心病机为肝肾失调,治疗主张调治肝肾,内外合治,多法并用。临证分虚实辨证,虚证常见肝肾阴虚证,内治常用自拟紫地养户汤以滋肾养肝、活血祛风,外治常用自拟首归息痒方熏洗坐浴以补血活血、祛风止痒;实证常见肝经湿热证,内治常用自拟逍遥泻肝汤以清肝利湿、通络止痒,外治常用自拟苦柏止痒方熏洗坐浴以清热利湿止痒。同时针对外阴白色病变患者局部色素减退、瘙痒明显、疼痛破溃或因瘙痒抓破的情况,常用自拟紫麻愈溃油局部外涂以消斑生肌。

It is believed that the pathogenesis of white lesions on the vulva lies in liver and kidney dysharmony,and the principle of regulating liver and kidney is recommended,with a combination of internal and external treatment,and using multiple methods.Clinically,it is differentiated into deficiency and excess.For deficient patients,liver-kidney yin deficiency is most common,for which self-made Zidi Yanghu Decoction(紫地养户汤)is used for internal treatment to nourish the kidney and liver,invigorate blood and dispel wind;self-made Shougui Xiyang Formula(首归息痒方)for fumigation,washing and sitz bath is used as external treatment to supplement and invigorate blood,dispel wind and relieve itching.Damp-heat in the liver channel is the most common excess syndrome,for which the internal treatment is self-made Xiaoyao Xiegan Decoction(逍遥泻肝汤)to clear the liver and drain dampness,unblock collaterals and relive itching,and the external treatment is self-made Kubai Zhiyang Formula(苦柏止痒方)for fumigation,washing and sitz bath in order to clear heat,drain dampness and relieve itching.If there is accompanied local hypopigmentation,obvious itching,painful ulcers,or scratching due to itching,self-made Zima Yukui Oil(紫麻愈溃油)is often applied topically to eliminate macules and engender flesh.