国医大师王琦从过敏体质论治斑秃经验
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摘要
王琦教授基于"体病相关论"阐释了斑秃与过敏体质之间的密切相关性,以"辨体-辨病-辨证"的三辨诊疗模式为临床理论指导,不仅关注患者之病兼以调患者之体。在诊疗过程中,王琦教授先辨识患者的过敏体质,再根据斑秃的病症以及不同病程中证型的变化而灵活加减用药,调理过敏体质专用药为乌梅、蝉蜕、野生赤芝、制何首乌,四药相配,驱散风热之邪又能养阴生津,收中有散,每获良效。王教授将治病与调体相结合,既改善了患者的过敏性体质,防止斑秃复发,又针对斑秃的病情对症下药从而改善症状,为斑秃的诊治提供了行之有效的理论指导及治疗方案。
Based on "body constitution and disease relevance theory",Professor Wang Qi expounds the close relevance between alopecia areata(AA) and allergic constitution;guided by clinical theory of the treatment mode "constitution differentiation,disease differentiation and dialectics",Professor Wang Qi not only focuses on patients' disease but also conditions patients' body constitution.In the diagnosis and treatment process,Professor Wang Qi first identifies the patients' allergic constitution,then adds or reduces the medicine according to the syndrome of disease and the changes of syndrome pattern in different disease courses.The designated medicines for conditioning allergic constitution are smoked plum,periostracum cicada,wild ganoderma lucidum,radix polygoni multiflori praeparata.The compatibility of the four medicines not only improves patients' allergic constitution,prevents the reoccurrence of AA,but also disperses wind-heat,nourishes Yin and promotes body fluid.It astringes and meanwhile disperses,producing an excellent effect every time.Professor Wang combines disease treatment and constitution conditioning,which not only improves the patients' allergic constitution,prevents the re-occurrence of AA,but also provides a remedy special for the disease according to disease conditions,so as to improve the symptoms.It's a feasible and efficacious theory guidance and treatment proposal for the treatment of AA.
Based on "body constitution and disease relevance theory",Professor Wang Qi expounds the close relevance between alopecia areata(AA) and allergic constitution;guided by clinical theory of the treatment mode "constitution differentiation,disease differentiation and dialectics",Professor Wang Qi not only focuses on patients' disease but also conditions patients' body constitution.In the diagnosis and treatment process,Professor Wang Qi first identifies the patients' allergic constitution,then adds or reduces the medicine according to the syndrome of disease and the changes of syndrome pattern in different disease courses.The designated medicines for conditioning allergic constitution are smoked plum,periostracum cicada,wild ganoderma lucidum,radix polygoni multiflori praeparata.The compatibility of the four medicines not only improves patients' allergic constitution,prevents the reoccurrence of AA,but also disperses wind-heat,nourishes Yin and promotes body fluid.It astringes and meanwhile disperses,producing an excellent effect every time.Professor Wang combines disease treatment and constitution conditioning,which not only improves the patients' allergic constitution,prevents the re-occurrence of AA,but also provides a remedy special for the disease according to disease conditions,so as to improve the symptoms.It's a feasible and efficacious theory guidance and treatment proposal for the treatment of AA.
引文
[1]GILHAR A,ETZIONI A,PAUS R.Alopecia areata[J].N Engl J Med,2012,366(16):1515-1525.
[2]LEE H W,JUN J H,LEE J A,et al.Acupuncture for treating alopecia areata:a protocol of systematic review of randomised clinical trials[J].BMJ Open,2015,5(10):8841.
[3]TOSTI A,DUQUE-ESTRADA B.Treatment strategies for alopecia areata.[J].Expert Opin Pharmacother,2009,10:1017-1026.
[4]WISEMAN M C,SHAPIRO J,MACDONALD N,et al.Predictive model for immunotherapy of alopecia areata with diphencyprone[J].Arch Dermatol,2001,137(8):1063-1068.
[5]陈霞,曹毅.斑秃的中医论治[J].光明中医,2011,27(4):804-805.
[6]王琦.中医体质学研究与应用[M].北京:中国中医药出版社,2012.
[7]郭红卫,郝飞,吴志华.斑秃免疫学发病机制研究进展[J].中国皮肤性病学杂志,2009,21(3):179-181.
[8]李雪.斑秃的中医证型与病情、疗效及预后关系的前瞻性研究[D].广州:广州中医药大学,2011.
[9]黄峥烨,秦海红,谢韶琼,等.斑秃患者Th1细胞分化相关基因IL-12和STAT4的表达及意义[C].北京:2009全国中西医结合皮肤性病学术会议论文汇编,2009:1172-1174.
[10]黄卫宁,侯显曾,卢浩锵,等.T淋巴细胞亚群与斑秃发病关系的研究[J].皮肤性病诊疗学杂志,2007,14(4):208-210.
[11]罗敏,黄进华,廖朝晖,等.斑秃患者血清γ干扰素和白介素10水平的研究[J].皮肤性病诊疗学杂志,2004,11(1):6-8.
[12]代秀菊,涂平,秦俭,等.几种细胞因子与斑秃发病关系的初步研究[J].中华皮肤科杂志,2002,50(1):52.
[13]欧阳莹,王华,蒋利萍,等.儿童斑秃与Th1/Th2型细胞因子关系的临床研究[J].重庆医科大学学报,2010,35(9):1394-1397.
[14]周静,丁杨峰,杨勤萍,等.T细胞因子在斑秃发病中的作用[J].中国皮肤性病学杂志,2010,22(1):23-26.
[15]黄卫宁,侯显曾,卢浩锵,等.斑秃患者血清IFN-γ、IL-12、IL-4的检测[J].皮肤性病诊疗学杂志,2009,16(4):232-234.
[16]GOH C,FINKEL M,CHRISTOS P J,et al.Profile of 513 patients with alopecia areata:associations of disease subtypes with atopy,autoimmune disease and positive family history[J].J Eur Acad Dermatol Venereol,2006,20(9):1055-1060.
[17]KUCHABAL S D,KUCHABAL D S.Alopecia Areata Associated with Localized Vitiligo[J].Case Rep Dermatol,2010,2(1):27-31.
[18]KURTEV A,ILIEV E.Thyroid autoimmunity in children and adolescents with alopecia areata[J].Int J Dermatol,2005,44(6):457-461.
[19]李水凤,张小婷,戚世玲,等.尘螨过敏可能是斑秃患者早发和重型的危险因素之一[J].中华皮肤科杂志,2014,47(1):48-50.
[20]章星琪.斑秃发病机理探讨[J].皮肤性病诊疗学杂志,2015,22(2):144-147.
[21]陈东,王芹.斑秃发病病因研究进况[J].现代医药卫生,2013,28(5):718-722.
[22]盖海山.王琦临床方药应用十讲[M].北京:中国中医药出版社,2006:4.
[23]郑璐玉,张惠敏,王琦.王琦教授治疗泛发性湿疹1例[J].天津中医药,2012,29(6):612-613.
[2]LEE H W,JUN J H,LEE J A,et al.Acupuncture for treating alopecia areata:a protocol of systematic review of randomised clinical trials[J].BMJ Open,2015,5(10):8841.
[3]TOSTI A,DUQUE-ESTRADA B.Treatment strategies for alopecia areata.[J].Expert Opin Pharmacother,2009,10:1017-1026.
[4]WISEMAN M C,SHAPIRO J,MACDONALD N,et al.Predictive model for immunotherapy of alopecia areata with diphencyprone[J].Arch Dermatol,2001,137(8):1063-1068.
[5]陈霞,曹毅.斑秃的中医论治[J].光明中医,2011,27(4):804-805.
[6]王琦.中医体质学研究与应用[M].北京:中国中医药出版社,2012.
[7]郭红卫,郝飞,吴志华.斑秃免疫学发病机制研究进展[J].中国皮肤性病学杂志,2009,21(3):179-181.
[8]李雪.斑秃的中医证型与病情、疗效及预后关系的前瞻性研究[D].广州:广州中医药大学,2011.
[9]黄峥烨,秦海红,谢韶琼,等.斑秃患者Th1细胞分化相关基因IL-12和STAT4的表达及意义[C].北京:2009全国中西医结合皮肤性病学术会议论文汇编,2009:1172-1174.
[10]黄卫宁,侯显曾,卢浩锵,等.T淋巴细胞亚群与斑秃发病关系的研究[J].皮肤性病诊疗学杂志,2007,14(4):208-210.
[11]罗敏,黄进华,廖朝晖,等.斑秃患者血清γ干扰素和白介素10水平的研究[J].皮肤性病诊疗学杂志,2004,11(1):6-8.
[12]代秀菊,涂平,秦俭,等.几种细胞因子与斑秃发病关系的初步研究[J].中华皮肤科杂志,2002,50(1):52.
[13]欧阳莹,王华,蒋利萍,等.儿童斑秃与Th1/Th2型细胞因子关系的临床研究[J].重庆医科大学学报,2010,35(9):1394-1397.
[14]周静,丁杨峰,杨勤萍,等.T细胞因子在斑秃发病中的作用[J].中国皮肤性病学杂志,2010,22(1):23-26.
[15]黄卫宁,侯显曾,卢浩锵,等.斑秃患者血清IFN-γ、IL-12、IL-4的检测[J].皮肤性病诊疗学杂志,2009,16(4):232-234.
[16]GOH C,FINKEL M,CHRISTOS P J,et al.Profile of 513 patients with alopecia areata:associations of disease subtypes with atopy,autoimmune disease and positive family history[J].J Eur Acad Dermatol Venereol,2006,20(9):1055-1060.
[17]KUCHABAL S D,KUCHABAL D S.Alopecia Areata Associated with Localized Vitiligo[J].Case Rep Dermatol,2010,2(1):27-31.
[18]KURTEV A,ILIEV E.Thyroid autoimmunity in children and adolescents with alopecia areata[J].Int J Dermatol,2005,44(6):457-461.
[19]李水凤,张小婷,戚世玲,等.尘螨过敏可能是斑秃患者早发和重型的危险因素之一[J].中华皮肤科杂志,2014,47(1):48-50.
[20]章星琪.斑秃发病机理探讨[J].皮肤性病诊疗学杂志,2015,22(2):144-147.
[21]陈东,王芹.斑秃发病病因研究进况[J].现代医药卫生,2013,28(5):718-722.
[22]盖海山.王琦临床方药应用十讲[M].北京:中国中医药出版社,2006:4.
[23]郑璐玉,张惠敏,王琦.王琦教授治疗泛发性湿疹1例[J].天津中医药,2012,29(6):612-613.
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