| 引用本文: |
李禹希, 刘朝圣, 李想, 何可为.基于“一气周流”理论辨治玫瑰痤疮浅析[J].湖南中医药大学学报,2025,45(12):2396-2400[点击复制] |
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| 基于“一气周流”理论辨治玫瑰痤疮浅析 |
| 李禹希,刘朝圣,李想,何可为 |
| (湖南中医药大学第一附属医院, 湖南 长沙 410007) |
| 摘要: |
| 玫瑰痤疮是临床难治性皮肤病，病因病机复杂，既往以“热邪”进行辨治，疗效有限。“一气周流”理论强调人体气化无端，为阐释复杂病机提供了动态整体观。本文基于该理论探讨玫瑰痤疮的诊疗方法，结合临床实践，认为枢机不利、气机升降失常是玫瑰痤疮的核心病机，中焦失枢、右路不降、左路不升均可致“一气”升降失常而为病，据此提出“复轴运轮”的治疗原则。具体而言，“中焦失枢，上热下寒”用苓甘五味姜辛夏杏大黄汤加减以清上温下、复运中轴；“右路不降，肺胃蕴热”用枇杷清肺饮加减以清泻肺胃、通降右路；“左路不升，肝郁气滞”用丹栀逍遥散加减以疏肝凉血、通达左路。附验案一则，以飨同道。 |
| 关键词: 玫瑰痤疮 一气周流 上热下寒 分型论治 黄元御 |
| DOI：10.3969/j.issn.1674-070X.2025.12.022 |
| 投稿时间：2025-06-26 |
| 基金项目:湖南省教育厅科学研究重点项目（24A0254）；博润皮肤科研究生（导师）基金项目（KH002475）。 |
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| Differential diagnosis and treatment of rosacea based on the theory of "circumfluence of qi" |
| LI Yuxi, LIU Chaosheng, LI Xiang, HE Kewei |
| (The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan 410007, China) |
| Abstract: |
| Rosacea is a clinically refractory dermatosis with complex causative factors and pathogenesis. In the past, it was differentiated and treated based on the concept of "heat pathogen," but the therapeutic efficacy was limited. The theory of "circumfluence of qi" emphasizes the endless circulation of qi transformation in the human body, providing a dynamic holistic perspective for interpreting complex pathogenesis. Based on this theory, this article explores the diagnostic and therapeutic methods for rosacea. Combining with clinical practice, it is believed that impaired function of pivotal mechanisms and abnormal ascending and descending of qi movement constitute the core pathogenesis of rosacea. Dysfunction of the middle-jiao as the pivot, failure of the right pathway to descend, and failure of the left pathway to ascend can all lead to abnormal ascending and descending of qi, resulting in the disease. Based on this, the therapeutic principle of "restoring the axis (spleen and stomach) to drive the wheel (qi movement)" is proposed. Specifically, for "middle-jiao dysfunction as the pivot with upper heat and lower cold," modified Linggan Wuwei Jiangxin Xiaxing Dahuang Decoction is used to clear upper heat, warm lower cold, and restore the middle axis's function; for "failure of the right pathway to descend with lung and stomach heat accumulation," modified Pipa Qingfei Drink is employed to clear and purge lung and stomach heat and facilitate the descent of the right pathway; for "failure of the left pathway to ascend with liver qi stagnation," modified Danzhi Xiaoyao Powder is utilized to soothe the liver, cool the blood, and facilitate the ascent of the left pathway. A verified medical record is attached for the reference of fellow practitioners. |
| Key words: rosacea circumfluence of qi upper heat and lower cold treatment based on pattern classification HUANG Yuanyu |
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