银翘散加减治疗皮肤病的文献研究

【作者】 张晏豪；

【导师】 李刘坤；

【作者基本信息】 北京中医药大学 ， 中医临床基础， 2009， 硕士

【摘要】 银翘散一方出自清代著名温病学家吴鞠通所撰的《温病条辨》,由金银花、连翘、竹叶、荆芥、薄荷、牛蒡子、豆豉、桔梗、甘草、芦根等10味中药组成。原方虽仅治疗风温等病初期风热袭卫之证,但其加减之方,却广泛用于治疗风温发疹、伏暑初起表里同病等证。近几十年来,在现代临床上,银翘散加减被广泛用于内科、儿科、五官科等疾病的治疗,尤其是用于治疗多种皮肤疾病,并取得了非常良好的效果。本文研究认为,银翘散乃辛凉清解之剂,方中以银花、连翘为君,辛凉轻清,透邪解毒,配以薄荷、荆芥、桔梗等宣肺透表之品,使全方成清疏兼顾之剂。临床既可治疗温病初起风热袭卫而证见发热、微恶风寒等证者,也可治疗温病初起但热不寒,或经治疗恶寒已解而里热不甚者。故用于皮肤病治疗时,不必拘泥于有无恶寒表证。风温发疹与许多皮肤病的病因病机相似,多因外邪侵袭卫表,内窜营分,使营卫不和,肌肤血络气血瘀滞所致。这也正是治疗风温发疹的银翘散去豆豉加细生地丹皮大青叶倍元参方用于治疗多种皮肤病的理论依据。现代医学研究证明,许多皮肤病的发生与细菌、病毒的感染有关,而现代中药药理研究表明,银翘散加减方中的主要药物如银花、连翘等,有着很好的抗细菌、抗病毒作用,从而为银翘散加减治疗皮肤病提供了实验依据。论文对各种皮肤病应用银翘散加减方的频次和银翘散加减治疗皮肤病的药物使用情况进行了分析。结果显示,银翘散加减治疗的皮肤病达20多种,但其中以水痘、风疹、疱疹、过敏性紫癜、麻疹、痤疮、玫瑰糠疹等疾病为多,而荨麻疹、湿疹、风热疮、脓疱疮、痒疹、丹痧、丹毒、猩红热等疾病,虽也用银翘散加减治疗,但病例较少。在药物使用上,银翘散中的主药金银花、连翘、薄荷、牛蒡子等,也是使用次数和使用剂量最多的药物。大量临床统计数据和具体治疗验案都充分证实,银翘散加减治疗多种皮肤病都有很好的疗效,其中尤以治疗各病中的风热证型疗效最为突出。论文还对银翘散的外用法进行了探讨,认为创制银翘散的外治法是十分必要和可行的,可将其制为水洗剂、膏剂、离子透入剂等,与银翘散内服剂配合,以进一步提高皮肤病的治疗效果。更多还原

【Abstract】 Yinqiao san is originated from Wen Disease Differentiation written by Wu Jutong in qing dynasty, its composition are honeysuckle, forsythia, mint, Arctii, Salvia, habitat, Scrophulariaceae, etc. its indication is in the initial stage of wind febris,causing skin rashes and redness because of wind febris at take-shaped skin, later generation apply it to the treatment of skin diseases, and achieved good effect. In recent decades, Yinqiao san is widely used in internal medicine, paediatrics, ophthalmology etc in clinic, especially for the treatment of a variety of skin diseases, and have achieved very good effects.In this paper, Yinqiaosan is considered as pungent cool and cooling-relieving therapy, honeysuckble and Fructus Forsythiae Suspensae are principal drug, pungent cool , removal the pathogenic factor and detoxification, with Herba Menthae Haplocalycis, Herba Schizonepetae Tenuifoliae, Radix Platycodi. Yinqiaosan can be used at the beginning of Wen disease with fever, bad cold, such as aversion to wind, but also the treatment of disease early temperature is not cold but the heat, or chills. Therefore, for the dermatological treatment, do not to stick to rigidly any evidences of chills and superficial zheng.Modern medical research shows that the incidence of many skin diseases were caused by bacteria, viruses, and the modern Chinese Pharmacological studies have shown that addition and subtraction of Yinqiaosan medicines such as the main Fangzhong Yinhua, forsythia, etc., have a good anti-bacterial, antiviral activity, so as to plus or minus of Yinqiaosan provides the experimental basis for skin diseases.The origin of a disease and pathogenesis is similar between exanthesis by wind febris with many other eruptive skin diseases,which was caused by invasion of exogenous evil, then into yingfen, ying-wei disharmony,skin blood stasis due to blood stagnant. This is theoretical basis for the treatment of skin disease which was used Yinqiao for exanthesis by wind febris .The drug applications of Yinqiaosan frequently used for various skin diseases were analyzed in the project. The results showed that the number of skin diseases by the treatment of Yinqiaosan is more than 20 kinds, but to chicken pox, rubella, herpes, allergic purpura, measles, acne, pityriasis rosea are most, while urticaria, eczema, wind heat sores, impetigo, prurigo, Dan fever, erysipelas, scarlet fever and other diseases, although Yinqiaosan used for the treatment, but fewer cases. The main drugs of Yinqiaosan are honeysuckle, forsythia, mint, Fructus Arctii,which are frequently used and doses is larger.A large number of clinical statistical data and specific treatment of post-mortem cases are fully confirmed Yinqiao san has a very good treatment of a variety of skin effect, particularly in the treatment of the disease in the wind-heat effect of the most prominent evidence-based.The external usage of Yinqiaosan was discussed in this paper, the creation of external usage of Yinqiaosan is very necessary and feasible, the system can be for water lotion, cream, etc. Iontophoresis and Oral agent were used at the same time in order to further improve the therapeutic effect of skin disease.更多还原