李松莲 范洪桥 陈柏屹 刘丽芳

〔摘要〕 基于“玄府气液学说”从中医微观探讨神经性皮炎血虚风燥证的病因病机，认为该病病位核心在于玄府，阴血虚耗、玄府郁闭为该病的病机关键，治疗应以“养血润燥、开通玄府”为原则，强调养血开玄法的重要性。

〔关键词〕 玄府气液学说;养血开玄法;神经性皮炎;血虚风燥证

〔中图分类号〕R275.1       〔文献标志码〕A       〔文章编号〕doi：10.3969/j.issn.1674-070X.2020.11.009

〔Abstract〕 Based on the "Sweat Pores Qi Fluid theory"， the etiology and pathogenesis of neurodermatitis with blood deficiency and wind-dryness syndrome was discussed from the microscopic view of traditional Chinese medicine （TCM）. It is believed that the core of the disease lies in sweat pores， and Yin blood deficiency and consumption， sweat pores depression and close are the key to the pathogenesis of this disease. The treatment should be based on the principle of "nurturing the blood and moistening the dryness， opening sweat pores"， emphasizing the importance of "nurturing blood and opening sweat pores method".

〔Keywords〕 Sweat Pores Qi Fluid theory; nurturing blood and opening sweat pores method; neurodermatitis; blood deficiency and wind-dryness syndrome

神經性皮炎是一种常见的瘙痒性皮肤病，相当于中医“顽癣”“牛皮癣”，具有皮损肥厚坚硬，极易形成苔藓化等特点，以剧烈瘙痒为主要症状，时作时发，缠绵难愈，在治疗上颇为棘手。《圣济总录·疮肿门·诸癣》曰：“得于牛毒者，状似牛皮，于诸癣中最为痛厚，邪毒之甚者，俗谓之牛皮癣。”陈士铎《洞天奥旨·白壳疮》曰：“风癣、花癣、牛皮癣、杨梅癣，皆因毛窍受风湿之邪，而皮肤无气血之润，毒乃附之而生癣矣。”指出本病多由风、湿、热邪内生或外感，结聚于机体，气血阻滞，痰瘀内生，郁久化火而耗伤阴液，阴血不足化燥生风，气血津液输布失常导致脏腑、经络、官窍、腠理不得濡养，引起一系列临床症状的出现。本病病位在皮肤，与多个脏腑功能失常密切相关，但宏观辨证难以进行准确定位，故笔者拟从“玄府气液”微观辨证角度着眼，探讨神经性皮炎血虚风燥证的发病机制，认为其病位核心在于玄府，阴虚血耗、玄府郁闭是其发生、发展以及日久不愈的内在成因，并提出“养血开玄”的治疗方法。

1 玄府气液学说

《素问·水热穴论》最早提出“玄府”的概念。……