Yang Zhi-bo's Experience of Treating Rose Acne with Oral Administration of TCM and External Application of TCM
DOI:10.16367/j.issn.1003-5028.2022.05.0151
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1.Hunan University of Chinese Medicine, Changsha, Hunan, China, 410208
2.The Second Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, China, 410005
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XU Jing, ZHONG Liang, WU Jia-zhen, et al. Yang Zhi-bo's Experience of Treating Rose Acne with Oral Administration of TCM and External Application of TCM[DB/OL].(2023-09-15)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails#10.16367/j.issn.1003-5028.2022.05.0151
杨志波教授认为,玫瑰痤疮病机乃“内热上攻”,而情志失调、饮食不节、日晒过度等是诱发“血热内蕴”的重要因素。杨教授认为,玫瑰痤疮初发于肺,早期预防,多用枇杷叶、桑叶、黄芩、桑白皮、白茅根、白花蛇舌草、金银花等以疏风清热、解毒宣肺。若兼见烦躁、寐差、舌尖红等,则加栀子、莲子心以清心火,合欢皮以解郁安神,同时以淡竹叶、灯芯草引心火从小便而出,使邪有出路;在清“脾热”的基础上,重视固护“后天之本”,多用党参、白术、薏苡仁、茯苓、山药等,同时绝湿热生化之源,嘱患者忌“发物”。玫瑰痤疮好发于中年女性,治以疏肝解郁、清热凉血,同时调畅情志,兼顾养肝、柔肝,临床多用柴胡、玫瑰花、香附、白芍、栀子、牡丹皮、赤芍等。玫瑰痤疮后期,营血热盛,邪热入络,气血凝滞,痰、湿、瘀、热互结,用桃红四物汤加减,加夏枯草、皂角刺软坚散结、破瘀消癥,陈皮、浙贝母化痰利湿。杨教授认为,颜面部干燥症状及阴虚血热病机贯穿玫瑰痤疮发病始末,论治时应兼顾滋阴益气以调本护正。整个病程都要注意清热凉血、润燥滋阴,临床多用芦根、玉竹、牡丹皮、玄参、南沙参、麦冬、丹参、赤芍、白芍、铁皮石斛等凉血滋阴之品,在养阴药物中尤擅用铁皮石斛。杨教授认为,自然界与人体密不可分,为有机整体,基于“天人合一”与“药象理论”提出“以皮治皮”“以花治华”理论,在辨证论治本病时注重标本兼治,内外同调。
Professor Yang Zhi-bo believes that the pathogenesis of rose acea is "internal heat attack", while emotional disorder, improper diet and excessive sun exposure are important factors inducing "blood heat accumulation". Professor Yang believes that rose acne initially occurs in the lung and should be prevented in the early stage. Pipaye (,Folium Eriobotryae,), Sangye (,Folium Mori,), Huangqin (,Radix Scutellariae,), Sangbaipi (,Cortex Mori,), Baimaogen (,Rhizoma Imperatae,), Baihuasheshecao (,Herba Hedyotis Diffusae,), Jinyinhua (,Flos Lonicerae Japonicae,), etc., can be used to dispel wind and clear heat, detoxify and ventilate the lung. If irritability, poor sleep and red tongue tip are also seen, Zhizi (,Fructus Gardeniae,) and Lianzixin (,Plumula Nelumbinis,) are add-ed to clear the heart fire, and Hehuanpi (,Cortex Albiziae,) is used to relieve depression and calm the mind. At the same time, Danzhuye (,Herba Lophatheri,) and Dengxincao (,Medulla Junci,) are used to induce the heart fire from urination, so that the patho-gens can have a way out. On the basis of clearing the "spleen heat" , "acquired foundation" should be paid attention to, Dangshen (,Radix Codonopsis,), Baizhu (,Rhizoma Atractylodis Macrocephalae,), Yiyiren (,Semen Coicis,), Fuling (,Poria,), Shanyao (,Rhizoma Dioscoreae,), etc. can be adopted. In order to avoid the source of generation and transformation of dampness-heat, the patients should be far away from "volatiles." Rose acne is common in middle-aged women. It is treated with soothing the liver and relieving depression, clearing heat and cooling blood, combined with regulating emotions, nourishing and softening the liver. Chaihu (,Radix Bupleuri,), Meiguihua (,Flos Rosae Rugosae,), Xiangfu (,Rhizoma Cyperi,), Baishao (,Radix Paeoniae Alba,), Zhizi (,Fructus Gar-deniae,), Mudanpi (,Cortex Moutan,), Chishao (,Radix Paeoniae Rubra,), etc. are widely used in clinical practice. In the later stage of rose acne, the blood heat of nutrient ,qi, is abundant, the pathogenic heat enters the collaterals,qi, and blood are stagnant, and the phlegm, dampness, blood stasis and heat are intermingled. Modified Peach Kernel and Carthamus Four Substances Decoction can be used. Xiakucao (,Spica Prunellae,), Zaojiaci (,Spina Gleditsiae,) can be added to soften hard lump, break blood stasis and elimi-nating abdominal mass; Chenpi (,Pericarpium Citri Reticulatae,) and Zhebeimu (,Bulbus Fritillariae Thunbergii,) can be added to resolve phlegm and remove dampness. Professor Yang believes that the symptoms of facial dryness and the pathogenesis of yin deficiency and blood heat run through the beginning and end of rose acne. In terms of treatment, we should give consideration to nourishing yin and ,qi, to regulate the essence and protect the healthy ,qi,. The whole course of the disease should pay attention to clearing heat and cooling blood, moistening dryness and nourishing yin. Clinically, Lugen (,Rhizoma Phragmitis,), Yuzhu (), Mudanpi (,Cortex Moutan,), Xuanshen (,Radix Scrophulariae,), Shanshashen (,Radix Adenophorae,), Maidong (,Radix Ophiopogonis,), Dansh-en (,Radix Salviae Miltiorrhizae,), Chishao (,Radix Paeoniae Rubra,), Baishao (,Radix Paeoniae Alba,), Tiepishihu (,Caulis Dendro-bii,), etc. can be often used to cool blood and nourishing yin. Tiepishihu (,Caulis Dendrobii,) is especially widely adopted. Professor Yang believes that nature and human body are inseparable and are an organic whole. Based on the "unity of heaven and man" and "medicine image theory" , he puts forward the theories of "treating skin with skin" and "nourishing body with flowers". In the treatment of rose acne based on syndrome differentiation, he pays more attention to treating manifestation and root cause, the interior and exterior concurrently.
玫瑰痤疮中药内服中药外敷桃红四物汤铁皮石斛杨志波
rose acneoral administration of TCMexternal application of TCMPeach Kernel and Carthamus Four Substances DecoctionTiepishihu (Caulis Dendrobii)Yang Zhi-bo
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