“营卫周流”理论视域下银屑病论治探讨

Discussion on the Diagnosis and Treatment of Psoriasis from the Perspective of the “Ying-Wei Circulation” Theory

摘要: 文章基于“营卫周流”理论探讨银屑病的病机及治疗，为中医治疗银屑病提供新的思路。先以《黄帝内经》关于营卫的论述为依据，从营卫起源、营卫运行对营卫产生及运行规律进行总结，提出内经“营卫周流”理论，即营气和卫气按照时间节律在脏腑经络间周流循环。在此基础上，根据营卫周流不息的生理特性，提出银屑病的产生总病机为营卫壅塞，核心因素为热邪，核心病机为外邪侵袭、营卫壅滞，五脏衰弱、营卫乏源，脏腑邪实、营卫受遏。治疗以流通营卫为大法，可予祛除外邪、流通营卫，调补脏腑、助运营卫，疏涤内邪、调和营卫，以冀营卫流通，银屑病趋向痊愈。

Abstract: Based on the “Ying-Wei Circulation” theory, this paper explores the pathogenesis and treatment of psoriasis, providing new ideas for the treatment of psoriasis in Traditional Chinese Medicine (TCM). First, drawing on the discussions about Ying-Wei in Huangdi Neijing, this paper summarizes the origin of Ying-Wei and the laws governing the generation and operation of Ying-Wei from the perspectives of Ying-Wei’s origin and operation, and puts forward the “Ying-Wei Circulation” theory, that is, Ying-Qi (Nutritive Qi) and Wei-Qi (Defensive Qi) circulate among Zang-Fu organs (viscera) and meridians in accordance with the time rhythm. On this basis, according to the physiological characteristic of the unceasing circulation of Ying-Wei, this paper proposes that the general pathogenesis of psoriasis is the obstruction of Ying-Wei, with pathogenic heat as the core factor. The core pathogenesis includes invasion of external pathogens leading to stagnation of Ying-Wei; weakness of the five Zang organs resulting in an insufficient source of Ying-Wei; and accumulation of pathogens in Zang-Fu organs causing blockage of Ying-Wei. The fundamental principle of treatment is to promote the circulation of Ying-Wei. Specific methods include eliminating external pathogens to smooth Ying-Wei circulation; regulating and tonifying Zang-Fu organs to assist Ying-Wei operation; and clearing internal pathogens to harmonize Ying-Wei. It is expected that through these methods, Ying-Wei circulation can be restored, and psoriasis can tend to be cured.