基于“卫气稽留”理论论治寻常型银屑病

Treatment of Psoriasis Vulgaris Based on the Theory of “Wei-Qi Retention”

摘要: 银屑病作为临床难治性疾病之一，其发病机制复杂且缠绵难愈。本文以《黄帝内经》“卫气稽留”理论为根基，系统阐释其从红斑迸发、斑块固着到燥屑脱落的全程演变规律，其病机可归结为肺脾肾亏虚导致的卫气稽留，并在此基础上进一步发展为血热，血瘀，血燥三大病理改变。针对这一复杂病程演变并结合临床实际，提出了七种辨证治法，即辛凉轻宣以散卫热，凉血散血以清血热、养血润燥以生卫源、活血祛瘀以疏卫道、补肺益气以行卫气、健脾化湿以澄卫源、补肾纳气以固卫根，如此方能营卫得源、清浊得分，卫气得行，血脉得通、卫行得畅，身无邪扰、内外皆安。本文通过整合古籍文献与现代医学研究，不仅为寻常型银屑病的中医药治疗提供了理论依据，也为临床实践开拓了新的理论支撑与实践路径。“卫气稽留”理论来源于《黄帝内经》，基于“卫气稽留”理论，结合现代医学对寻常型银屑病的描述，认识到根据“卫气稽留”理论所描述的病理状态与寻常型银屑病的分期相契合，据此提出基于“卫气稽留”理论论治寻常型银屑病，旨在为中医药治疗寻常型银屑病提供新的思路。

Abstract: Psoriasis, a clinically refractory disease characterized by complex pathogenesis and protracted course, is systematically elucidated in this paper through the theoretical framework of “wei-qi retention” from the Huangdi Neijing. The study clarifies its holistic evolutionary pattern from erythema eruption and plaque consolidation to xerotic desquamation, attributing the pathogenesis to constitutional deficiencies of lung, spleen, and kidney leading to wei-qi retention, which further develops into three major pathological transformations: blood-heat, blood-stasis, and blood-dryness. Addressing this complex pathological progression and integrating clinical practice, seven syndrome-differentiated therapeutic strategies are proposed: (1) dispersing Wei-heat through pungent-cool exterior-releasing methods; (2) clearing blood-heat via cooling and dispersing blood; (3) nourishing blood and moistening dryness to regenerate wei-qi sources; (4) promoting blood circulation and removing stasis to unblock wei-qi pathways; (5) reinforcing lung and benefiting qi to regulate wei-qi movement; (6) strengthening spleen and resolving dampness to purify wei-qi origins; and (7) tonifying kidney and anchoring qi to consolidate wei-qi roots. These approaches aim to restore the origin of ying-qi and wei-qi, differentiate clarity from turbidity, ensure smooth circulation of wei-qi and blood vessels, and ultimately achieve internal-external homeostasis free from pathogenic disturbances. By integrating classical medical literature with modern research, this study not only provides theoretical foundations for traditional Chinese medicine (TCM) treatment of psoriasis vulgaris but also opens new theoretical and practical pathways for clinical practice. The “wei-qi retention” theory, rooted in the Huangdi Neijing, demonstrates remarkable alignment with modern medical descriptions of psoriasis vulgaris staging. This paper proposes a TCM therapeutic approach for psoriasis vulgaris based on the “wei-qi retention” theory, aiming to offer novel perspectives for TCM treatment of this condition.