王宪庆基于“营卫不和”理论从胆、肺、肾论治黄汗病经验

Wang Xianqing’s Experience in Treating Huang Han Disease Based on the Theory of “Disharmony between the Defensive and Nutritive Qi” through the Gallbladder, Lung, and Kidney Meridians

摘要: 关于黄汗病的认识，多数医家从湿邪郁久化热立论，根据黄汗病的“汗黄”、“四肢头面肿”、“痈脓”等典型临床表现来对症治疗。因此对于本病的诊治往往忽视了其病机的关键在于营卫不和，进而不能全面认识黄汗病的发生、发展与演变。本文依据王宪庆主任的临证经验，提出黄汗病的首要病因在于长期汗出而腠理不固，水湿之邪郁留皮下，其核心病机在于“营卫不和、湿邪泛溢”，其后因湿邪阻滞，影响营卫气血的生化与周流，不断演变直至兼夹他病。王宪庆主任本着“奇之不去则偶之”的复方施治理念，从胆、肺、肾治疗黄汗病，并强调标本同治、随病治之的治疗原则，依据病情变化而灵活施策，从而为该病的诊治提供了重要的诊疗思路与临床经验。

Abstract: Regarding the understanding of Huang Han disease, most physicians base their theories on the prolonged stagnation of dampness transforming into heat. They treat the condition symptomatically based on typical clinical manifestations such as “yellow sweat” “swelling of the limbs, head, and face,” and “boils and pus”. Consequently, the diagnosis and treatment of this disease often overlook the key pathogenesis of disharmony between the nutritive and defensive qi, thereby failing to comprehensively understand the onset, development, and progression of Huang Han disease. Drawing upon Director Wang Xianqing’s clinical experience, this paper proposes that the primary cause of Huang Han disease lies in prolonged sweating coupled with weakened skin pores, allowing dampness pathogens to stagnate beneath the skin. The core pathogenesis involves “disharmony between the nutritive and defensive qi, with dampness pathogens overflowing.” Subsequently, obstruction by dampness pathogens impairs the generation and circulation of nutritive and defensive qi and blood, leading to progressive evolution and the potential involvement of other diseases. Adhering to the compound prescription philosophy of “treating the unusual when the unusual persists,” Director Wang Xianqing addresses Huang Han disease through the gallbladder, lung, and kidney systems. He emphasizes the therapeutic principles of treating both symptoms and root causes simultaneously, and adapting treatment to the disease’s progression. This flexible approach based on clinical changes provides crucial diagnostic insights and clinical experience for managing this condition.