从“风火湿燥”分期辨治小儿唇风

Staged Differentiation and Treatment of Pediatric Lip Wind from "Wind, Fire, Dampness and Dryness"

  • 摘要: 总结汪受传教授从风火湿燥分期辨治小儿唇风的临证经验,认为小儿唇风的病位在唇,病本于脾胃,发病因素与风、火、湿、燥相关。临证根据小儿唇风发生发展过程中的邪正盛衰、虚实变化及症状特征不同分为“三期四证”进行辨治。急性初起期以红肿痛痒为主要表现者,病机为脾胃积热、风火上攻,治宜清胃泻脾、散火消风,方选泻脾散合清胃散加减。慢性持续期以湿疹糜烂为主要表现者,病机为脾胃湿热、风湿热蕴,治宜清热护阴、祛湿消风,方选消风散加减;以干燥脱屑为主要表现者,病机为脾胃虚热、血燥生风,治宜滋阴泻火、养血消风,方选四物消风饮加减。缓解易复期以症轻易复为主要表现者,病机为脾胃伏风、燥湿留恋,治宜培中消风、润燥化湿,方选增液汤加味。

     

    Abstract: The paper summarizes the experience of Professor Wang Shouchuan in staged differentiation and treatment of pediatric lip wind. It is considered that the lesion of pediatric lip wind is located in the lip, the disease originates from the spleen and stomach, and the pathogenic factors are related to wind, fire, dryness and dampness. Clinical diagnosis and treatment of pediatric lip wind can be divided into three phases and four syndrome types according to the exuberance and decline of pathogenic and healthy qi and changes of excess and deficiency and different symptom profiles. In the acute initial phase with redness, swelling, pain and itching as the main manifestation, the pathogenesis is heat accumulation in spleen and stomach, and wind and fire attacking upwards, the treatment should be to clear stomach and purge spleen, disperse fire and eliminate wind, and modified Xiehuang San combined with Qingwei San should be used. In the chronic persistence stage with eczema vesicles as the main manifestation, the pathogenesis is dampness heat in spleen and stomach, and wind-damp-heat accumulation, the treatment should be to clear heat and protect yin, dispel dampness and eliminate wind, and modified Xiaofeng San should be used; while when dryness and desquamation are the main manifestation, the pathogenesis is deficiency heat in spleen and stomach, and blood dryness generating wind, the treatment should be to nourish yin and purge fire, nourish blood and eliminate wind, and modified Siwu Xiaofeng Yin should be used. In the remission and recurrence stage with mild symptoms and easy recurrence as the main manifestation, the pathogenesis is latent wind in the spleen and stomach, and dryness and dampness being retained, the treatment should be to promote the middle-jiao and eliminate wind, moisten dryness and resolve dampness, and modified Zengye Tang should be used.

     

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