李敏 张冰

[摘要]皮膚病是困扰人们健康的临床常见病，中医药治疗皮肤病具有独特优势。张冰教授治疗皮肤病经验丰富，疗效明确，总结出独特的识病用药经验。张冰教授认为皮肤病不同发展阶段皆有热邪作祟，其病机各异，初期常见风毒蕴结腠理，进一步发展则热毒侵入血分，继而热瘀互结不行，久则有阴血亏虚生燥等。据此总结出祛除热邪的“清法”四则，包括清透、清解、清润和清行的用药思想。用药中，以药寒凉之气为本，结合五味，气味合参，其中辛寒性味可凉散风热，辛寒还可行散瘀热;甘寒可祛热润燥;苦寒性味则可清泻里热，辨证用于不同阶段、不同证型皮肤病，医理明晰，用药精准，临床疗效显著。本文探讨张冰教授治疗皮肤病的“清法”四则的用药经验，以期为临床防治皮肤病提供参考。

[关键词]皮肤病;热邪;清法;气味合参;用药经验

[中图分类号] R275  [文献标识码] A   [文章编号]2095-0616（2021）23-0112-05

Professor Zhang Bing's experience in treating dermatosis with "clearing methods" by emphasizing the medicinal propertiesl

LI  Min    ZHANG  Bing

1.School of Pharmacy， Shaanxi University of Chinese Medicine， Shaanxi， Xi'an 712046， China;2.School of Chinese Materia Medica， Beijing University of Chinese Medicine， Beijing 100029， China

[Abstract] Dermatosis is a common clinical disease that threatens people's health. Traditional Chinese medicine has unique advantages in treating dermatosis. Professor Zhang Bing has rich experience in treating skin diseases， with definite curative effect. He has summed up his unique experience in recognizing disease and using drugs. Professor Zhang thought that dermatosis was caused by pathogenic heat in different stages of development， and their pathogenesis was different. In the early stage， it was common for wind-toxin amassed in striae， and heat-toxin invaded xuefen （blood tier） with further development， then develop into heat and blood stasis， and for a long time there were deficiency of yin-blood， which leads to dryness and so on. On the basis of this， four "clearing methods" to dispel heat pathogen were summarized， including the medical principles of clearing and outthrusting， clearing and resolving， clearing and moistening， and clearing and moving. In the use of medicine， it was based on the cold qi of the medicine， combined with five flavors， in which the medicinals pungent in flavor and cold in property can clear heat and dispel pathogenic wind， and also can clear hear and resolve stasis; the medicinals sweet in property and cold in flavor can clear heat and moisten dryness; the medicinals bitter in property and cold in flavor can clear and purge the internal heat. Syndrome differentiation was used in different stages and different syndrome types of dermatosis， with clear medical principle， accurate medication， and remarkable clinical effect. This paper discussed Professor Zhang's experience in treating dermatosis with four principles of "clearing methods"， in order to provide reference for clinical prevention and treatment of dermatosis.

[Key words] Dermatosis; Heat pathogen; Clearing methods; Odor combination; Medication experience

张冰教授是国医大师颜正华学术经验传承人，潜心学习继承孟河医派的学术思想和临床技能30余年[1-2]，精研本草，勤于临床，不固守古法，善学习新知，对于皮肤病、脾胃病等病证临床治疗效果显著[3-7]。张冰教授临证治疗尤其重视药物的药性和安全性[8-9]，对于皮肤病的治疗，经过多年的钻研探索，总结出独特的用药思想和用药经验，主要是以“清”为主，注重气味合参。结合病证的不同特点，在疾病不同发展阶段，以寒凉药性为本，结合五味，形成独特的基于“清法”四则治疗皮肤病的用药理论和组方用药经验。……