摘 要 总结归纳了中医药治疗硬皮病主要临床和实验研究报道，说明了中医药在硬皮病治疗中的作用和价值。强调局灶性硬皮病和系统性硬化症应分开进行中医药诊疗，局灶性硬皮病治疗以控制病情进展为主，宜采用清热解毒和辛凉解表类药物，慎用活血化瘀和温阳补肾药；系统性硬化症可采用皮肤病变三期分治以及 “寒热-络病-脏腑”辨证体系指导治疗，坚持中西医结合治疗系统性硬化症。针对中医药治疗硬皮病研究现状提出了六点建议。

关键词 硬皮病 中医药 临床研究

中图分类号：R593.25 文献标识码：A 文章编号：1006-1533（2017）S1-0059-04

Value and thinking of traditional Chinese medicine for the treatment of scleroderma

GUO Gang

（Scleroderma Specialist， Hebei Ridge Hospital affiliated to Hebei Medical University， Shijiazhuang 050091， China ）

ABSTRACT The major clinical and experimental studies on traditional Chinese medicine（TCM） for the treatment of scleroderma are summarized and its role and value are also explained. The differentiated diagnosis and treatment should be emphasized for focal scleroderma and systemic sclerosis， in which the disease progression should be controlled first and then the medicines with the function of heat-clearing and cool diaphoresis should be used while the medicines with the functions activating blood circulation to dissipate blood stasis and warming yang and tonifying kidney should be carefully used for focal scleroderma， and skin lesions should be treated for three period partition and then the patients should be treated under the guideline of “cold and heat-collateral disease-viscera” differentiation system and meanwhile the combination therapy of traditional Chinese and western medicine should be continuously adopted for systemic sclerosis. Six suggestions are proposed based on the current research situation of traditional Chinese medicine in the treatment of scleroderma.

KEY WORDS scleroderma； traditional Chinese medicine； clinical research

硬皮病（scleroderma）是以局限性或彌漫性皮肤及内脏器官结缔组织硬化或纤维化，最终发生萎缩为特征的免疫性疾病。临床一般分为系统性硬化症（systemic sclerosis，SSc）和局灶性硬皮病（localized scleroderma，LS）两种。发病机理尚不清楚，炎症之后的纤维化是本病特征，现有的治疗手段远未能满足临床治疗的需要，缺乏针对性的特效药物[1]。

中医药在控制病情进展、改善皮肤代谢、防治肢端溃疡、保护内脏功能以及提高生活质量等方面有肯定疗效。笔者致力于中西医结合治疗硬皮病近20年，现就中医药方法在治疗硬皮病的价值以及思路简述如下，供大家参考。

1 中医药治疗硬皮病临床研究

中医古代虽然没有“硬皮病”病名，但有很多符合硬皮病和雷诺征的文献描述，可见本病是一个古老疾病。在临床研究方面，早在1975年天津医学院附属医院皮肤科报道治疗26例全身性硬皮病患者，采用活血化瘀药与参芪桂附等温阳益气药同用，取得一定疗效[2]；……