论黄褐斑的病因病机

旨在探讨黄褐斑的病因病机,根据笔者的临床体悟,结合历代有关文献论述,认为黄褐斑的病因病机可分为：①胞宫失常,在女子有月经不调之功能失常和胞宫、阴户损伤及积而致之实质失常,在男子为浊热内盛和肾精亏虚;②冲任损伤,如毒邪感染房室不节,径伤冲任,精血耗损及寒、痰、瘀等损及冲任;③肝气郁结,与藏血不足、疏泄太过或疏泄不及有关;④精血不足;⑤肾阳亏虚;⑥脾胃不调,含脾胃气虚、脾胃阳虚、胃阴虚和胃热盛;⑦浊热内盛,分肝胆湿热和脾胃湿热;⑧感受风邪和日光毒。掌握这些对指导辨证治疗有重要意义。

Discussion on the etiological factors and pathogenesis of chloasma

This article presents the discussion on the etiological factors and pathogenesis of chloasma.On the basis of clinical experience and related literature from every dynasty,the author concludes that the causes and pathogenesis of chloasma can be summarized into 8 aspects: 1.Menoxenia,lesion of uterus and cunnus,tumors in pelvic cavity in women;excessive heat and deficiency of kidney essence in men.2.Damages in Chong-Ren meridians,e.g.infection of pathogen which goes directly into Chong-Ren;exhaustion of essence blood;coldness,phlegm or blood clot congests within the Chong-ren meridians.3.Stasis of liver-qi induced by insufficiency of blood storage and dysfunction in conveyance and dispersion.4.Shortage of essence blood.5.Lack of kidney-yang.6.Disharmony between spleen and stomach,including deficiency of spleen-stomach qi,spleen-stomach yang,and stomach yin,and surplus of stomach heat.7.Flooding of turbidness and heat,like moisture and heat in liver-gallbladder and in spleen-stomach.8.Invaded by exogenous pathogen of wind and sunlight.Knowing these points has great significance on directing therapy according to syndrome differentiation.