夏武 刘怀珍

【摘 要】 黄褐斑是脏腑功能失调导致的面部色素代谢障碍性皮肤病，中医属“面尘”“面奸”“面风黧”等范畴。文章從病因、病机，辨证、施治等方面总结安徽省名中医刘怀珍教授治疗黄褐斑的临诊经验。刘怀珍教授认为黄褐斑多因肝郁血瘀，木滞土壅所致。病位在肝脾肾三脏，病属本虚标实，本虚为肝脾肾三脏不足，标实为瘀血内阻，提出疏肝养血、活血化瘀、培补中焦的治疗原则，临床以加味逍遥散为底方随证加减，取得良好疗效。

【关键词】 黄褐斑;刘怀珍;临床经验

【中图分类号】R249.2/.7   【文献标志码】 A    【文章编号】1007-8517（2021）12-0098-03

Abstract：Chloasma is a kind of skin disease with disorder of facial pigment metabolism caused by dysfunction of viscera. This paper summarizes the clinical experience of Treating Chloasma by director Liu huaizhen，a famous TCM doctor in Anhui Province，from the aspects of etiology，pathogenesis，dialectics and treatment. Director Liu believes that chloasma is mainly caused by stagnation of liver qi and blood stasis，and stagnation of wood and soil. The disease is located in the liver，spleen and kidney，the disease belongs to the deficiency of the liver，spleen and kidney，and the deficiency is the deficiency of the liver，spleen and kidney，and the standard is the internal resistance of blood stasis. The therapeutic principles of soothing the liver and nourishing blood，promoting blood circulation and removing blood stasis，and strengthening the middle energizer are put forward. The Modified Xiaoyao Powder is used as the base prescription in clinic，and good curative effect is achieved in clinic.

Keywords：Chloasma;Liu Huaizhen;Clinical Experience

黄褐斑是现代社会常见的一种颜面部色素沉着性皮肤病，中青年女性为高发人群，本病临床表现为对称分布在阳明经所循行的颧额颊部，一般边缘清楚，表面光滑，无自觉症状，表现为黄褐色或深褐色斑片。与日晒、季节等环境因素以及妊娠、长期服避孕药此类内分泌等因素有关[1]。本病病因复杂，难治而易复发，目前治疗停留在有效改善、控制病情阶段，以综合治疗为思路，尚没有单一特效的疗法。

刘怀珍教授，系安徽中医药大学第一附属医院老年内分泌科主任，安徽省名中医，硕士生导师，从事内分泌临床、科研、教学30余年，对内分泌代谢性疾病有独到的见解。笔者在跟师学习过程中发现，大多黄褐斑患者都伴随着月经不调，患者的黄褐斑也伴随月经的正常而淡化甚至褪去，现将刘怀珍导师多年治疗黄褐斑经验简以归纳如下。

1 病因病机