摘要
介绍2021年5月28日门诊收治的1例6.5岁女患儿,主诉为颈部、肘窝、腘窝等屈侧红斑、丘疹伴瘙痒6年余。现症见皮肤干燥,纳眠差,平素性急,大便干,小便黄,舌尖偏红,苔白厚腻,脉略数。西医诊断:特应性皮炎;中医诊断:四弯风,心火脾虚,兼有肝风内动。治以清利心火,健脾除湿,平肝息风止痒,基于特应性皮炎“心-脾”相关理论,以藤角培土清心方加减,包含太子参、白术、炒鸡内金、生地黄、淡竹叶、莲子心、栀子、白茅根、连翘、山羊角、白鲜皮、炒蒺藜、钩藤、防风、甘草。配合耳穴压豆处方:耳穴心、肝、脾、风溪。佐以中药外洗、他克莫司软膏等局部治疗。继以藤角培土清心方联合培土清心耳穴压豆法等治疗,3周后皮疹基本消退,瘙痒控制,一般情况良好,舌苔、舌质改善明显,病情趋于稳定。培土清心方为《特应性皮炎中医诊疗专家共识》的经典方,特应性皮炎患儿在发病过程中心肝火旺常见,在此方基础上增加山羊角、钩藤,为藤角培土清心方,具有清利心火、健脾除湿,平肝息风止痒之效,外治配以培土清心耳穴压豆疗法(自拟),以心、肝、脾、风溪耳部四穴为主穴位,对于特应性皮炎患儿复杂病机,采用中西医结合综合治疗,疗效确切。
The paper introduces one case of a 6.5-year-old child with atopic dermatitis who is admitted on May 28,2021.The chief complaint is erythema,papules and itching on the neck,elbow fossa and popliteal fossa for more than 6 years.The symptoms include dry skin,poor sleep,impatience,dry stool,yellow urine,reddish tongue tip,thick and greasy fur,and slightly rapid pulse.The diagnosis in Western medicine was atopic dermatitis,and the traditional Chinese medicine diagnosis was Siwan-feng(四弯风).The pathogenesis of traditional Chinese medicine for this case is heart liver-fire hyperactivity,spleen deficiency and dampness accumulation.Based on the theory of“heart-spleen”of atopic dermatitis of traditional Chinese medicine,the prescription of Tengjiao Peitu Qingxin formula(藤角培土清心方)is modified,including Taizishen(Radix Pseudostellariae),Baizhu(Rhizoma Atractylodis Macrocephalae),Chao Jineijin(fried Rhizoma Atractylodis Macrocephalae),Shengdihuang(Radix Rehmanniae),Danzhuye(Herba Lophatheri),Lianzixin(Plumula Nelumbinis),Zhizi(Fructus Gardeniae),Baimaogen(Rhizoma Imperatae),Lianqiao(Rhizoma Imperatae),Shanyangjiao(Caprae Seu Ovis Cornu),Baixianpi(Cortex Dictamni),Chaojili(fried Fructus Tribuli)and Gouteng(Ramulus Uncariae Cum Uncis),Fangfeng(Radix Saposhnikoviae),Gancao(Radix Glycyrrhizae).Peitu Qingxin ear acupoint pressing beans therapy include acupoint for heart,liver,spleen and Fengxi(风溪).External washing with traditional Chinese medicine,tacrolimus ointment and other local treatments are assisted.3 weeks after the treatment of Tengjiao Peitu Qingxin formula plus Peitu Qingxin ear acupoint pressing beans therapy,the rash basically subsides,the itching is controlled,the general condition is good,the tongue coating and tongue quality is ameliorated significantly,and the condition tends to be stable.Peitu Qingxin formula is a classic prescription of the Expert Consensus on TCM Diagnosis and Treatment of Atopic Dermatitis.That it is commonly used for patients with atopic dermatitis who have hyperactive liver fire in the onset process.On the basis of this formula,Shanyangjiao and Gouteng are added to form Tengjiao Peitu Qingxin formula,which has the effect of clearing heart fire,invigorating spleen dehumidification,flattening liver,quenching wind and relieving pruritch,which is combined with external treatment with Peitu Qingxin ear acupoint pressing beans(self-designed)therapy,with the heart,liver,spleen,Fengxi ear four points as the main acupoints.For complex pathogenesis of atopic dermatitis children,comprehensive treatment in the integrative medicine has the exact effect.
作者
赵巍
孟威威
吴卿
ZHAO Wei;MENG Weiwei;WU Qing
出处
《中医临床研究》
2023年第12期117-119,共3页
Clinical Journal Of Chinese Medicine
基金
河南省重点研发与推广专项(科技攻关)(212102311121)
国家中医临床研究基地科研专项(2019JDZX094)
河南省中医专科诊疗中心建设项目(豫中医医政[2020]63号)。
关键词
特应性皮炎
培土清心
耳穴压豆
Atopic dermatitis
Peitu Qingxin
Ear acupoint pressing beans
