基于痰瘀窠囊理论运用桂枝茯苓丸加减治疗特应性皮炎

Treatment of Atopic Dermatitis with Modified Guizhi Fuling Pills Based on the Theory of Phlegm-Stasis Evolving into Kennang

摘要:

特应性皮炎（AD） 属中医学四弯风、湿疮等范畴，其病程漫长、迁延难愈的特点，契合中医学“怪病多痰”“久病多瘀”的理论。眭道顺教授认为，AD总属本虚标实之证，其病情反复发作、皮损肥厚难消之根，非独邪气之盛，实乃正气之虚与痰瘀等病理产物相互交织所致。AD其病变初以正虚为本，痰瘀酿生；日渐邪恋不去，痰瘀互结；日久窠囊形成，深伏络脉。故AD的病机核心在于痰瘀互结之“窠囊”的形成，治疗宜以化痰祛瘀、补虚固本为法，应用桂枝茯苓丸加减治疗可获良效。

Abstract:

Abstract： Atopic dermatitis （AD） falls into the categories of cubito-popliteal eczema and eczema in traditional Chinese medicine （TCM）. Its prolonged course and refractory nature align with the TCM theories that "undiagnosed diseases are often caused by phlegm" and "prolonged illnesses often involve blood stasis. " Professor SUI Daoshun proposes that AD is characterised by a syndrome of deficiency in the root and excess in superficiality. The recurrent attacks and intractable， thickened skin lesions are not solely due to pathogenic exuberance but arise from the intertwining of healthy qi deficiency with pathological products such as phlegm and stasis. In the early stage， AD is characterized by root deficiency， with phlegm and stasis gradually generated. As the condition persists， pathogenic factors linger，and phlegm and stasis become mutually intermingled. Over time，a kennang （encysted accumulation of phlegm and blood stasis） forms，deeply latent in the collateral vessels. Therefore，the core pathogenesis of AD lies in the formation of "kennang" due to the intermingling of phlegm and stasis. The treatment should focus on resolving phlegm，eliminating stasis，tonifying deficiency，and cultivating the vital essence. The application of modified Guizhi Fuling Pills can achieve certain therapeutic effects.