基于“火郁发之”理论论治玫瑰痤疮

Treating Rosacea Based on the Theory of “Fire Depression Is to Be Dispersed”

摘要: 玫瑰痤疮是一种常见的慢性炎症性皮肤病，易反复发作，迁延难愈。在中医理论中，其核心病机主要为“火郁”于面部。本文以《内经》提出的“火郁发之”理论为基础，系统探讨玫瑰痤疮的中医病因与病机。该病多因情志不畅、饮食失宜或外邪侵袭，致肺胃积热或肝郁化火，热邪郁闭不得外透，上蒸于面颊而发病。本文强调治疗以“发之”为根本原则，注重透散郁火，而非一味清热泻火。临床应结合辨证，灵活选用疏风清热、宣肺解郁、凉血活血及疏肝理气等法，引导郁热外透，以期达到调畅气血、消红退肿之效。本研究为中医诊治玫瑰痤疮提供了理论依据与临床新思路。

Abstract: Rosacea is a common chronic inflammatory skin disease characterized by its recurrent nature and tendency to become persistent. In Traditional Chinese Medicine (TCM) theory, its core pathogenesis is primarily attributed to “fire depression” localized in the face. Based on the “fire depression is to be dispersed” theory proposed in the Inner Canon, this article systematically explores the TCM etiology and pathogenesis of rosacea. The disease often arises from emotional distress, dietary irregularities, or external pathogen invasion, leading to accumulated heat in the lung and stomach systems or liver depression transforming into fire. This results in heat pathogens becoming depressed and failing to be vented outward, subsequently steaming upward to the cheeks and causing the condition. This paper emphasizes that the fundamental treatment principle is “dispersing”, focusing on dispersing and venting the depressed fire rather than solely relying on clearing heat and purging fire with cold-natured herbs. Clinically, treatment should be based on pattern differentiation, flexibly selecting methods such as dispersing wind and clearing heat, diffusing the lung and relieving depression, cooling blood and activating blood, or soothing the liver and regulating qi, to guide the depressed heat outward. The aim is to achieve the therapeutic effects of regulating and harmonizing qi and blood, reducing redness, and subsiding swelling. This study provides a theoretical basis and new clinical insights for the TCM diagnosis and treatment of rosacea.