银屑病,俗称牛皮癣,反复发作,终身不愈,给患者的身体健康及精神状况带来了极大的困扰.轻者皮肤斑斑点点影响美观,瘙痒不已影响社交和睡眠;重者全身密布红斑,皮肤大量脱屑,甚至发展为全身红肿的红皮病或全身脓疱,高热不退,关节疼痛无法行走,甚至危及生命.

本文认为"毒"为寻常型银屑病发病原因,毒为邪之渐,为无用之物、满溢之物,内外毒入于血分,发于皮肤,"毒"可分阴阳;"瘀毒互结"为本病的病机,瘀贯穿银屑病发展始终,血气否涩,瘀从毒结,瘀久蕴毒,瘀毒结聚;"虚"为本病的发病基础,以肝肾亏虚,阴血不足为本,加之脾肾阳虚,卫外不固;正气不足,邪气居之,虚损生积,瘀毒互结,导致本病反复发作,缠绵难愈;临证用药谨守病机,立解毒活血之法,分期而论,侧重不同,同时寒热并用,调和阴阳,顾护脾胃,为临床治疗寻常型银屑病提供新思路.

人体是一个非常复杂的生物体,当皮肤受到损伤时,身体就会想办法去修复它.而瘢痕(俗称"疤痕"),就是人体用来填补伤口的"创可贴".

银屑病是一种易反复发作的慢性炎症性皮肤病,是皮肤科常见的难治性皮肤病之一.文章主要介绍李元文教授治疗银屑病的临床经验,李教授在前人对银屑病病因病机认识的基础上提出了应用病络理论指导银屑病的诊治,提出了辨证与组织病理的关系,并用于指导治疗,取得了满意的临床疗效.

问:玫瑰糠疹需要治疗吗? 答:玫瑰糠疹具有自愈性,一般在6～8周内可以自愈(参见2019年3月刊《春季瘙痒,留心玫瑰糠疹》一文).如果皮损少、无瘙痒或轻度瘙痒就不需要治疗.如果皮损处瘙痒明显,可以外用炉甘石洗剂或皮质类固醇激素类软膏,如糠酸莫米松乳膏、曲安奈德乳膏、丁酸氢化可的松乳膏等,必要时口服抗组胺药物;严重的患者可以口服抗病毒药物,如阿昔洛韦、泛昔洛韦等.

问:玫瑰糠疹的症状有哪些? 答:玫瑰糠疹是一种以覆有糠状鳞屑的玫瑰色斑疹、斑丘疹为典型皮损的炎症性皮肤病."玫瑰"是指色红如玫瑰;"糠疹",糠即是谷皮,是指皮疹糠秕样脱屑.好发于中青年,以春秋季多见.起病时往往先出现一个淡红色或玫瑰红色的椭圆形或圆形斑片,直径约2～3厘米,覆盖细碎糠秕样鳞屑,此称为"原发斑"或"母斑",因为多发生于躯干、四肢近端等不易暴露部位,又常常没有自觉症状,所以很多时候不易发现.

目的 观察香柏酊对头部脂溢性皮炎湿热证的临床疗效,确立头部脂溢性皮炎湿热证外用药治疗规范.方法 将符合头部脂溢性皮炎湿热证诊断标准的90例患者随机分为治疗组36例、阳性对照组(联苯苄唑组)36例及阴性对照组(安慰剂组)18例,治疗组外用香柏酊,联苯苄唑组外用联苯苄唑溶液,安慰剂组外用安慰剂.疗程均为4周,分别于用药0、(14±3)、(28±3)天,痊愈者停药后(28±3)天进行访视,记录红斑程度、靶皮损面积、鳞屑程度、瘙痒程度以及脂溢程度积分,评价各组疗效;于用药4周时进行靶皮损真菌学镜检或培养,评价真菌学疗效.结果 治疗4周后,香柏酊组、联苯苄唑组、安慰剂组总有效率分别为88.89％、68.57％、25.0％,组间差异有统计学意义(P＜0.05).结论 香柏酊治疗头部脂溢性皮炎抑制鳞屑及缓解瘙痒方面疗效优于联苯苄唑,临床总疗效亦优于联苯苄唑溶液.

目的:通过临床观察客观评价复方香柏颗粒对头部脂溢性皮炎的临床疗效,确立头部脂溢性皮炎外用药治疗的研究规范.方法:选取2017年11月至2018年6月北京中医药大学东方医院收治的头部脂溢性皮炎患者80例,随机分为观察组和对照组,每组40例,观察组外用复方香柏颗粒;对照组外用2％酮康唑洗剂.观察治疗前和治疗4周后的各症状积分及临床疗效.结果:治疗后皮损面积、红斑、鳞屑、脂溢及瘙痒等症状较治疗前均有明显改善(P<0.05),且在鳞屑、脂溢和瘙痒方面,改善明显优于对照组(P<0.05).2组治疗4周后,观察组40例,总有效率为90％;对照组38例,总有效率65.8％,观察组显著高于对照组(P<0.05).结论:复方香柏颗粒外用治疗头部脂溢性皮炎疗效好,安全性高,值得临床推广使用.

OBJECTIVE: To investigate effect of Yupingfeng granules, prepared with Chinese Medicines, on the wound healing and on the expression of aquaporin 3 (AQP3) and the skin barrier in the animal models of atopic dermatitis (AD). METHODS: Acute skin lesions of AD models were prepared using 2,4-dinitrochlorobenzo (DNCB) in mice and animals were treated with either Yupingfeng granules or placebo for two weeks. Skin wound healing outcome was assessed by measuring skin thickness, weight (quality) of the skin, and trans-epidermal water loss (TEWL). Expression of AQP3 mRNA and protein was assessed by reverse transcriotion polymerase chain reaction (RT-PCR) and immunoblotting, respectively. RESULTS: Yupingfeng granule treatment resulted in significant acceleration of wound healing with 63.64% efficiency, which was significantly higher than that of placebo granule treatment (31.82%, P < 0.01 by Wilcoxon Rank-sum test). Skin thickness, weight of the wounded skin, and TEWL were significantly higher in the AD models compared to that of normal animals. Treatment with Yupingfeng granules resulted in significant decrease in skin thickness [(937 +/- 31) vs (360 +/- 21) mu m, P < 0.01], weight of the wounded skin [(42 +/- 4) vs (24 +/- 5) mg, P < 0.01], and TEWL [(30 +/- 4) vs (13 +/- 4) g.h(-1) m(-2), P < 0.01]. Yupingfeng granules also significantly down-regulated mRNA and protein expression of AQP3 in the animal models. CONCLUSION: Our findings suggested that Yupingfeng granules could be used in AD treatment. (C) 2018 JTCM. All rights reserved.

手是人劳作、生活里最常用的器官之一,十分灵巧.不管是能人巧匠做出的精美工艺品,还是日常生活里家人做出的粗茶淡饭,都需要手的操作.手的功能不可小觑,所以更需保养. 日晒、外伤、化学损伤,小伤害无处不在 手部皮肤与身体其他部位并没有太大差异,但掌部角质层极厚、没有毛囊和皮脂腺,局部皮肤水分的保持、皮脂对皮肤的濡润都受到了一定限制.而且手部皮肤接触外界物质如化学物质(如家庭清洁剂等)、日光照射、物理刺激(外伤、烫伤等)等较其他部位更多,就更加容易受到损伤.当受到外界各种因素影响时,手部皮肤会失去弹性,导致皮肤组织断裂,从而皲裂、老化.

目的:建立青石止痒软膏的质量控制标准.方法:对青石止痒软膏的原辅料进行质量标准检查,检查其装量、粒度及微生物限度;采用薄层色谱法对青石止痒软膏中青黛、苦参和黄柏进行鉴别;采用高效液相色谱法测定甘石青黛膏中靛蓝及靛玉红的含量,色谱柱为Waters Symmetry Shiled-RP18(150 mm×4.6 mm,5μm),以甲醇-水(65:35)为流动相,流速1.0 mL/min,检测波长285 nm,柱温25℃.结果:青石止痒软膏的原辅料、3批甘石青黛膏装量、粒度及微生物限度均符合2010版《中华人民共和国药典》的有关规定;青石止痒软膏中青黛、苦参、黄柏的薄层色谱图斑点明显,阴性对照无干扰;靛蓝在2.35～4.7μg(r=0.9998)范围内,靛玉红在0.00832～0.2912μg(r=0.9996)范围内,与峰面积呈良好的线性关系.结论:本实验建立的方法快速简便,准确可靠,可作为该制剂的质量控制方法.

Professor LI Yuan-wen became a doctor for more than 30 years,and he was good at using TCM external treatment in common skin diseases and difficult diseases such as vitiligo,neurodermitis,psoriasis,postherpetic neuralgia,chronic urticariaand so on.Professor LI believed that the role of the TCM external treatment was as important as oral administration and intravenous administration.TCM external treatment has the characteristic of'simple,convenient,inexpensive,effective',and provides a broader space for the treatment of skin diseases.However,we must grasp the two principles in the application of external treatment:one is'different diseases are applied different drugs',while another is'different types of lesion need different drug dosage forms and medications'.Through several years of study,the author collated some experience as follows to discuss.

寻常痤疮是一种常见的慢性炎症性毛囊皮脂腺疾病,性激素水平失调成为痤疮发病机制的研究热点.其中研究表明,生物钟紊乱可引起激素水平异常,导致性激素水平失调而引起或加重痤疮.生物钟紊乱与中医"起居无常"不谋而合.本文拟从性激素角度探讨生物钟紊乱导致痤疮的现代医学机制,并分析生物钟紊乱导致痤疮中医病机.

Objective To observe the effect of Quyou granules in the treatment of multiple verruca plantaris and its effects on the immune function. Methods 60 patients with multiple verruca plantaris were divided into treatment group and control group according to random numbers table, 30 cases in each. Treatment group was treated with traditional Chinese medicine (TCM) Quyou granules 2 doses (4 bags), of which 1 bag adding to boiling water, 1 bag each time, 2 times a day;the other 1 plus alum 10 g, adding hot water and soaking the affected foot, 40 minutes each time, 1 times a day, 2 weeks for a course of treatment, the curative effect was observed after 2 courses of treatment. The control group was treated with liquid nitrogen, 1 times per 2 week, 4 weeks after treatment, the curative effect was observed. Results Total effective rate was 89. 7% in treatment group, which was significantly higher than that in the control group (55. 2%), the result had statistical significance (P<0. 05). Comparison of T cell subgroup, the treatment group had a certain effect on improving the peripheral immune cells,CD4+ was increased, CD8+was reduced, CD4+/CD8+was increased, while the control group almost had no effect. The recurrence rate was 7. 7% in treatment group which was obviously better than that was 50% in control group. Conclusion&nbsp;The Quyou granules in the treatment of multiple verruca plantaris is safe and effective, and the recurrence rate is low, and curative effect is significantly better than cryotherapy.

Objective:To observe the efficacy and safety of external Chinese prescription on multiple verruca vulgaris. Methods:80 cases were randomly divided into 2 groups, 40 cases in the treatment group treated with external Chinese prescription, 40 cases in the control group treated with liquid nitrogen cryotherapy. After 4 weeks, the clinical effects and the re-occurrence of the two groups were compared. Results:The effective rate of the treatment group was 80%while that of the control group was 50%. The re-occurrence rate of the treatment group was 6.25%, while that of the control group was 40%. Compared the two groups, the effect of the treatment group was better than that of the control group(P<0.05). Conclusion:Chinese prescription combined with cryotherapy has a good effect on multiple verruca vulgaris with low re-occurrence rate and less side effects.

Objective To explore the related factors of the heritage neuralgia before and after the intervention methods, provides the reference for the prevention of PHN. Methods Through the epidemio-logical investigation of 95 cases hospitalized patients, the patients’ general information, risk, lesion charac-teristics, combination of disease and treatment of data were done with hierarchical analysis. applied statis-tics methods to analyze , We established a Logistic regression model and designed the various factors as in-dependent variables, and then gradually selected variables the statistically significant data. was. Results PHN of risk factors include:herpes zoster degree of acute pain (P=0. 002,OR=14. 507),diabetes melli-tus(P =0.007,OR =7.066)OR malignant tumors(P =0.007,OR =25.978),skin lesions type(χ2 =13. 377,P=0. 010), the precursor of pain occurred (P=0. 015,OR=5. 366), age (Z= -2. 442,P=0. 015), the lesion area (Z= -2. 203,P=0. 028). And sex, site and inducing factors and the occurrence of PHN has nothing to do. PHN reduced favorable factors include:the onset of treatment time to start ( P=0. 008, OR=9. 785) and early treatment method (χ2 =9. 535,P =0. 009). Conclusion Postherpetic neuralgia after herpes zoster occurred mostly related to the degree of acute pain, followed by the merger of diabetes, malignant tumor, early treatment, skin lesions type, precursor pain occurs, lesion area and so on, while sex, place, inducing factors was not associated with the occurrence of this disease Herpes zoster as soon as possible and Treatment with TCM independently or combined with little hormones in the early stage of PTN do good to prevent the happening of PHN.

目的:观察西药结合三黄散治疗带状疱疹的疗效。方法:在常规使用抗病毒、营养神经、止痛药物的情况下,对照炉甘石洗剂调三黄散外涂带状疱疹(治疗组)与单纯炉甘石洗剂外涂(对照组)的疗效差异。结果:治疗组大大缩短了疱疹结痂的时间,并能有效地止痛和预防后遗神经痛的发生,观察组的疗效优于对照组(P<0.05)。结论:西药结合三黄散是治疗带状疱疹的一种疗效好,安全可靠的外用药。

目的观察解毒化瘀通络方颗粒剂治疗带状疱疹后遗神经痛毒损络瘀证的临床疗效,探讨解毒化瘀通络方治疗毒损络瘀型带状疱疹后遗神经痛的作用机理。方法将患者随机分为治疗组(解毒化瘀通络方口服)和对照组(腺苷钴胺肌注)各25例,疗程4周,分别于治疗前、治疗后2周及4周观察并记录患者临床证候积分,4周后判定疗效。结果治疗组总有效率明显高于对照组,证候积分及视觉模拟评分法(VAS)评分改善情况亦优于对照组。结论解毒化瘀通络方治疗带状疱疹后遗神经痛毒损络瘀证疗效肯定,可较大程度缓解疼痛,明显改善患者不适症状,提高患者生活质量。