基于“火郁发之”理论探讨火针治疗寻常型银屑病

Discussion on Fire Needling Therapy for Psoriasis Vulgaris Based on the Theory of “Stagnated Fire Should Be Dispersed”

摘要: 寻常型银屑病是一种慢性复发性炎症性皮肤病，其病机演变可概括为血热、血瘀、血燥三个阶段，核心在于“郁”。“火郁发之”出自《素问·六元正纪大论》，是治疗郁火证的总则。火针集“针”与“灸”于一体，具有开门逐邪、温通经络之功，恰合“发之”之旨。文章从“火郁发之”理论出发，探讨寻常型银屑病血热、血瘀、血燥的病机演变，阐释火针透热于外、温通化瘀、调养气血的作用机理，并结合验案加以佐证。火针通过“发”，即透热、通瘀、调气，使气血复其常道，为临床运用火针治疗寻常型银屑病提供理论依据。

Abstract: Psoriasis vulgaris is a chronic recurrent inflammatory skin disease, and its pathogenesis can be summarized into three stages: blood-heat, blood-stasis, and blood-dryness, with “stagnation” being the core mechanism. The theory of “stagnated fire should be dispersed” originates from Suwen∙Liuyuan Zhengji Dalun and serves as the general principle for treating stagnant fire syndrome. Fire needling integrates the functions of both acupuncture and moxibustion, possessing the effects of opening the portal to expel pathogens and warming and unblocking the meridians, which precisely aligns with the essence of “dispersion”. Based on the theory of “stagnated fire should be dispersed”, this paper discusses the pathogenic evolution of blood-heat, blood-stasis, and blood-dryness in psoriasis vulgaris, elucidates the mechanisms of fire needling in dispersing heat outwardly, warming and resolving stasis, and regulating and nourishing qi and blood, and provides clinical case verification. Through “dispersion”, namely dispersing heat, unblocking stasis, and regulating qi, fire needling restores the normal circulation of qi and blood, offering a theoretical basis for its clinical application in treating psoriasis vulgaris.