基于“气阴两虚、脉络瘀滞”病机论治瘢痕疙瘩

Treatment of Keloids Based on the Pathogenesis of “Deficiency of Qi and Yin, Stagnation of Collaterals and Vessels”

摘要: 瘢痕疙瘩(KD)为临床常见的难治性皮肤纤维化病变，多继发于创伤、烧伤、手术等皮肤损伤后，以瘢痕组织过度增生、超出原损伤范围为典型特征，不仅影响局部美观与功能，还常伴随疼痛、瘙痒等不适症状，严重降低患者生活质量，成为中西医临床治疗的难点问题。钟以泽教授是第一批四川省名中医，伍景平教授作为其传人，基于长期临床实践，结合中医经典理论，从“气阴两虚、脉络瘀滞”论治KD，明确疾病的核心病机与演变规律，并据此构建“益气养阴、活血通络”的治疗思路，临床应用疗效确切。文章从KD的中医病因病机入手，深入解析“气阴两虚、脉络瘀滞”病机内涵，系统阐述相应的分期治疗策略，结合临床验案总结辨治经验，以期为KD的中医规范化治疗提供参考。

Abstract: Keloid (KD) is a common clinical refractory skin fibrosis lesion, mostly secondary to trauma, burns, surgery, and other skin injuries, characterized by excessive hyperplasia of scar tissue beyond the scope of the original injury. It not only affects the local appearance and function, but also is often accompanied by pain, itching, and other discomfort symptoms, seriously reducing the quality of life of patients. It has become a difficult problem in the clinical treatment of traditional Chinese and Western medicine. Professor Zhong Yize was one of the first famous TCM doctors in Sichuan Province, and Professor Wu Jingping was his disciple. Based on the long-term clinical practice and the classic theory of traditional Chinese medicine, Professor Wu Jingping treated KD from “deficiency of both qi and Yin, stagnation of collaterals and vessels”, clarified the core pathogenesis and evolution of the disease, and established the treatment idea of “instilling qi and nourishing Yin, activating blood circulation and promoting collateralization”. Based on the TCM etiology and pathogenesis of KD, this article analyzes the pathogenesis of “deficiency of qi and Yin and stagnation of veins and collaterals”, systematically expounds the corresponding staged treatment strategy, and summarizes the experience of differential treatment combined with clinical trials, in order to provide a reference for the standardized TCM treatment of KD.