系统性硬化病中医药治疗进展【摘要】目的:通过中医理论研究及临床实践操作综合论述系统性硬化病(SSc)的病因病机、中医辨证分型及证型的客观化研究、中医药治疗等方面。着重介绍系统性硬化病的常规中医中药辨证分型、分期治疗及其它经验治疗。这也是目前中医药治疗该病的一个特色和亮点,值得进一步研究和探讨。硬皮病属中医“皮痹”范畴,该病多为本虚标实之证,其病机多认为是脾肾阳虚,气血瘀滞,在治疗上多以补脾益肾、活血化瘀为主。巢元方曰:“风湿痹状,或皮肤顽厚,或肌肉疼痛,由血气虚则受风湿而成此病,日久不愈入经络,搏于阳经,亦变全身手足不遂”。其病机可以概括为气血不足,外感寒湿风邪,致使寒凝肌腠,日久耗伤精血,脏腑虚损,气血瘀滞,实质为本虚标实之证。结果:强调在硬皮病的临证治疗中,不能拘泥于常规分期、分型治疗,应灵活应变,辨证论治,内服结合外治法,全面治疗硬皮病。Objective:throughthetheoreticalresearchandclinicalpracticeoftraditionalChinesemedicinecomprehensivetreatmentofsystemicsclerosis(SSc)ofetiologyandpathogenesis,TCMsyndromedifferentiationtypeandthetypeofobjectiveresearchandtreatmentoftraditionalChinesemedicine,etc.IntroducesthesystemicsclerosisofconventionaltreatmentoftraditionalChinesemedicineandexperience,andothertreatment.ThisisthetraditionalChinesemedicineintreatmentofthediseaseacharacteristicandbrightspot,deservesfurtherresearchanddiscussion.Sclerodermabelongto"bi"categoryoftraditionalChinesemedicine,thisdiseaseformoreofthisvirtualtheactualcard,itspathogenesisismorespleenkidneyYangdeficiency,bloodstasis,morethanonthetreatmentisgivenprioritytowithtonifyingspleenkidneyandpromotingbloodcirculationtoremovebloodstasis.chaoyuanfangsaid:"rheumatismbi,ordensethickskin,andmusclepain,iscomposedbyrheumatismdisease,bloodgasvirtualtimenotintothechannelsandcollaterals,inYangmeridians,alsobecomethebodyfoundinthebrotherhoodof".Itspathogenesiscanbesummarizedaslackofqiandblood,exogenouswindcolddampnessevil,causehaemorrheologicalnaturemuscleCou,timeconsumedJingXie,visceraisdeficient,qiandbloodstasis,theproofoftheessenceforthisvirtualtoreal.Results:thestressedintheclinicaltreatmentofscleroderma,notconstrainedintheconventionalstage,partingtreatment,shouldbeflexible,syndromedifferentiationandtreatment,theinternalandexternaltreatmentcombinedwithcomprehensivetreatmentofscleroderma.【关键词】系统性硬化病,中医药治疗,综述【正文】系统性硬化病(SSc)【1】,又称硬皮病(SCL)、进行性系统性硬化,是一种原因不明,临床上以局限性或弥漫性皮肤及内脏器官结缔组织纤维化,硬化及萎缩为特点的结缔组织疾病。临床分为二大类型:局限性硬皮病和系统性硬皮病(SS)。系统性硬皮病又分两亚型:肢端硬皮病和弥漫性硬皮病。本病呈世界性分布。患病率50~300/100万人口,发病率每年2.3~22.8/100万。发病高峰年龄30~50岁;儿童相对少见,女性多见,男女比率1:3~14。1.中医病名、病因、病机中医无硬皮病病名,根据其临床症状及病情过程,属“皮痹”、“脉痹”、“痹病”【2】范畴。如果累及内脏器官,则属“心痹”、“肾痹”、“肺痹”等。《内经》有“皮痹”的记载,《素问·痹论》说:“夫痹之为病,不痛何也……痹在于骨则重,在于脉则血凝而不流,在于筋则屈不伸,在与肉则不仁,在于皮则寒,故具此五者则不痛也”。指出了本病皮毛寒冷而不痛的症状。《素问遗篇·刺法论》云:“正气存内,邪不可干”,《素问·评热病论》云:“邪之所凑,其气必虚”,故脏腑功能失调、气血阴阳不足。隋·巢元方明确提出了本病的皮肤改变,云:“风湿痹病之状,或皮肤顽厚,或肌肉酸痛”。《圣济总录·皮痹》【3】云:“感于三气则为皮痹”,故皮痹的主要病因是外邪侵袭,其中以风、寒、湿邪为主.宋·吴彦夔《传信适用方》记述“人发寒热...