白癜风中医证治若干思考

从大量有关白癜风的中医文献入手,指出白癜风在古代即是中医学病名,并且目前存在中西医混淆名称的现象,应当予以纠正;结合自身的临床实践,总结了白癜风的病因主要包括病因基础和诱发因素。两方面因素,其中病因基础为发病之本,是本病发生发展的主要原因;诱发因素是发病的诱因或使病情加重的因素;并以此为基础提出本病的病理基础为肾虚血弱,气血失和是致病关键,风邪外袭是发病的重要诱发因素;通过分析,总结了几个临床上最常见的证型为风血相搏型、风湿外侵型、湿热风燥型、肝郁气滞型、肝肾不足型、淤血阻滞型、气血亏虚型。当临床面临"少症难辨"时,笔者提出把握疾病的发展规律,根据病变的不同时期临床特点,按照病变分期进行辨证论治。认为初期阶段的表现特点与风邪有关,所以选方用药上要着重考虑以祛风散邪为主,佐以调和气血;进展期多与脾胃运化失常,或肝气郁结,气机不畅有关,所以治疗以疏肝理脾,调理气血为主;稳定期的白癜风主要表现为肝肾亏虚的"虚"与瘀阻脉络"瘀",治疗当以补益肝肾与活血通络为主要治则,再佐以养血祛风;此外,在中医辨证治疗的同时结合现代中药学研究成果,中西互参,结合外治疗法,疗效更佳。

Some Thoughts on TCM Treatment of Vitiligo

From the Chinese literature of vitiligo,vitiligo is a disease name in ancient Chinese medicine. And there is a confusion between traditional Chinese medicine and Western medicine which should be corrected. Combining with self clinical practice,we summarized the causes of vitiligo including foundation causes and inducing factors. The onset foundation is the main reasons for the occurrence and development of this disease. The inducing factors are the predisposing factor or can aggravate their conditionand then we put forward the basic pathology is kidney and blooddeficiency,disharmony between Qi and blood and the external attack of wind evil is an important cause. Through the analysis,we summarize the common syndromes are wind and blood combating syndrome,wind- damp external attacking syndrome,damp- heat and wind dryness syndrome,liver qi stagnation syndrome,liver and kidney deficiencysyndrome,blood stasis blocksyndrome,deficiency of Qi and bloodsyndrome. When it is difficult to make the syndrome differentiation,the author proposes to grasp the law of development of the disease and according to clinical features in different phases of disease as well as the disease stage to make the treatment based on syndrome differentiation. It is believe that the initial stage performance characteristics is associated with the wind evil and the dispersing wind drugs should be considered complicated with drugs for regulating Qi and blood. In the advanced stage,it is mainly related to spleen and stomach disordersor liver qi stagnation. The treatment should be soothing liver and regulating spleen as well as regulating qi and blood. In the stability stage,the main manifestations are deficiency of liver and kidney and the blood stasis in collateral and the treatment should be tonifying liver and kidney and promoting blood circulation. and combined with drugs for nourishing blood ans expelling wind. Combined with the modern pharmacology research results and the external therapy,the combined treatment has bettercurative effect.