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1、Western Diagnosis & TCM Managementfor Common Skin Diseases常见皮肤病的西医诊断和中医治疗常见皮肤病的西医诊断和中医治疗Yong Ming Li, MD, PhD李永明李永明 博士博士 医师医师 针灸医生最常见的疾病是什么？ 答案不是经常治疗的疼痛或抑郁症，而是皮肤病。 针灸医生在“寻经取穴”时可以“顺便”检查患者的皮肤病变，这是其它科医生没有的方便条件。 但是，很多针灸医生没有受过皮肤病诊断的训练，只好视而不见。 美国是个移民国家，不同种族的病人皮肤病种类繁多，尤其是白种人皮肤癌发病率极高，不及时诊断，可能危及生命。 针灸师如果能够掌握
2、简单皮肤病诊断技能，对患者和提高行医水准都会十分有益。 中医中药和针灸在治疗一些炎症皮肤病和某些疑难皮肤病有很多优势，每位中医师和针灸师都应该在临床上探索使用。 Why an acupuncturist need to know skin diseases？针灸医生为什么需要皮肤疾病？针灸医生为什么需要皮肤疾病？Why an acupuncturist need to know skin diseases？针灸医生为什么需要皮肤疾病？针灸医生为什么需要皮肤疾病？ What is the most common condition encountered by an acupuncturist?
3、 The answer is not pain or depression but the skin problem. While locating acupoints, an acupuncturist has the advantage to review most skin lesions, but other specialists do not have. Unfortunately, many practitioners who have insufficient dermatological training choose to ignore skin problems. Var
4、ious complicated skin diseases might be seen in the USA and light skin individuals are special prone to skin cancer. An acupuncturist with basic dermatological expertise can be a great benefit to patients as well as to his/her own practice. Acupuncture and TCM herbs are known to be good alternative
5、options for certain skin diseases.1. 美国最常见皮肤病的分类2. 皮肤恶性肿瘤的临床特征和鉴别诊断3. 常见炎症皮肤病的分类和适合中医治疗的病症4. “望闻问切”在皮肤病诊断和鉴别诊断中的应用5. 中医药和针灸治疗病例介绍1. The classification of commonly seen skin diseases in the USA2. Clinical features and diagnosis of malignant skin tumors3.Commonly seen inflammatory skin diseases and co
6、nditions may be managed by TCM therapies4.Application of TCM diagnostic principles in the examination and screening of skin diseases5. Case analysis on TCM management Western Diagnosis & TCM Management for Common Skin Diseases常见皮肤病的西医诊断和中医治疗常见皮肤病的西医诊断和中医治疗Classification of common skin conditions常见皮肤
7、病分类常见皮肤病分类Skin diseases 皮肤病皮肤病变Non-inflammatory非炎症非炎症Neoplasm 肿瘤瘤Benign tumor良性良性肿瘤瘤 Malignant tumor 恶性性肿瘤瘤Non-neoplasm 非非肿瘤瘤Physiological change 生理改生理改变Pathological changes 病理改病理改变Inflammatory 炎症炎症Infection 感染感染Virus infection 病毒感染病毒感染Microorganism infection 菌菌类感染感染Non-infection 非感染非感染Auto immune自身
8、免疫自身免疫Non specific inflammation 非特异炎症非特异炎症Seborrheic keratosis (SK) 脂溢性角化病Melanocytic nevus (mole) 黑色素痣Solar keratosis (actinic keratosis) 日光性角化病Fibroepithelial polyp (skin tag) 纤维上皮息肉Epidermal cyst (sebaceous cyst） 表皮囊肿Verruca vulgaris, condyloma (wart) 寻常疣，湿疣Dermal scar (keloid) 皮肤疤痕，瘢痕疙瘩Dermatofi
9、broma 皮肤纤维瘤Neurofibroma 纤维神经瘤Hemangioma 血管瘤Basal cell carcinoma (BCC) 基底细胞癌Squamous cell carcinoma (SCC) 鳞状细胞癌Malignant melanoma (melanoma) 恶性黑素瘤Common non-inflammatory skin conditions常见非炎症皮肤病变常见非炎症皮肤病变Clinical Features and Diagnosis of Malignant Skin Tumors皮肤恶性肿瘤的临床特征和鉴别诊断皮肤恶性肿瘤的临床特征和鉴别诊断Basal cell
10、 carcinoma (BCC) 基底细胞癌Squamous cell carcinoma (SCC) 鳞状细胞癌Malignant melanoma (melanoma) 恶性黑素瘤Lymphoma, leukemia 淋巴瘤，白血病Soft tissue malignant tumor 软组织恶性肿瘤Metastatic cancer 转移癌Clinical Features of Malignant melanoma恶性黑素瘤的临床特征恶性黑素瘤的临床特征Eczema, atopic dermatitis 湿疹，特应性皮炎（异位皮炎）Allergic and contact dermat
11、itis 过敏性和接触性皮炎Lichen simplex chronicus 神经性皮炎Acne 痤疮，粉刺Folliculitis 毛囊炎Herpes infection 疱疹病毒感染Drug reaction 药物皮炎Arthropod bite reaction 蚊虫叮咬Dermatophysis 皮癣Psoriasis 银屑癣，牛皮癣Lupus erythematosus 红斑狼疮Uticaria 荨麻疹Alopecia areata 斑秃Common inflammatory skin conditions常见炎症皮肤病变常见炎症皮肤病变Eczema, atopic dermatit
12、is 湿疹，特应性皮炎Allergic dermatitis 过敏性性皮炎Urticaria reaction 荨麻疹Zoster 带状疱疹Lichen simplex chronicus 神经性皮炎Psoriasis 银屑癣Auto immune dermatitis 自身免疫皮炎Alopecia 脱发Wart, verruca 疣Skin Itching, pain 皮肤瘙痒、疼痛 Common Inflammatory Skin Diseases May Be Managed by TCM Therapies常见炎症皮肤病的分类和适合中医治疗的病症常见炎症皮肤病的分类和适合中医治疗的病症
13、Application of TCM Diagnostic Principles in the Examination and Screening of Skin Diseases“望闻问切望闻问切”在皮肤病诊断和鉴别诊断中的应用在皮肤病诊断和鉴别诊断中的应用望：望：Inspection闻：闻：Listening & smelling问：问：Inquiry切：切：PalpationTree Integrative Approaches in the Management of Eczema中西医结合治疗湿疹的三中方法中西医结合治疗湿疹的三中方法1.中药 Herbs2.针灸 Acupunctur
14、e3. 生活和水土的改变 Life & Land ChangesAcupuncture Points for Eczema Management治疗湿疹的常用针灸穴位治疗湿疹的常用针灸穴位神庭神庭 Shen Ting曲池曲池 Qu Chi通里通里 Tong Li合谷合谷 He Gu阳陵泉阳陵泉 Yang Ling Quan隐白隐白 Yin Bai足三里足三里 Zu San Li太冲太冲 Tai ChongAcupuncture Shu Points for Eczema Management治疗湿疹的常用针灸腧穴治疗湿疹的常用针灸腧穴风门风门 Feng Men肺腧肺腧 Fei Shu心腧心腧
15、Xin Shu脾腧脾腧 Pi Shu胃腧胃腧 Wei Shu三焦腧三焦腧 San Jiao Shu肾腧肾腧 Shen Shu定喘定喘 Ding ChuanLocal Acupuncture Area for Eczema Management治疗湿疹的局部针灸治区域治疗湿疹的局部针灸治区域重内因病表治里，祥外治殊途同归内治：四型1. 湿热：龙胆泻肝汤龙胆草、 黄芩、 栀子、 泽泻、 【木通】、 车前子、当归、 生地黄、 柴胡、 甘草脓疱：金银花、连翘；便干：大青叶2.血热：皮癣汤加减生地、丹皮、赤芍、黄芩、苦参、地肤子、白鲜皮、丹参、生甘草Dr Zhu Renkangs Experience
16、in Managing Eczema朱仁康治疗湿疹经验朱仁康治疗湿疹经验内治：3.脾湿：胃苓汤加减苍术、陈皮、茯苓、泽泻、六一散、白鲜皮胃呆：藿香、佩兰；腹胀：川朴、大腹皮4.阴伤：滋阴除湿法生地、元参、当归、丹参、茯苓、泽泻、白鲜皮、蛇床子禁忌：重用燥湿和利湿之品Dr Zhu Renkangs Experience in Managing Eczema朱仁康治疗湿疹经验朱仁康治疗湿疹经验外治：1. 湿敷：急性期渗出黄柏 或 马齿苋 或 生地榆30克煎汁，用纱布浸透，外敷2.药膏：各期均可以湿疹膏等2.粉剂：急性期药粉加植物油：青黛、螵蛸、锻石膏、冰片Dr Zhu Renkangs Exper
17、ience in Managing Eczema朱仁康治疗湿疹经验朱仁康治疗湿疹经验辨湿疹，要在湿热互结，治顽症用“全虫” 内治：二型1. 热盛型：龙胆草6、 黄芩9、 黄连6、 泽泻9、 栀子6、 车前草15生地黄15、 连翘9、槐花9、 甘草3 【木通3】便干：川军、枳壳；下焦湿热：黄柏；渗液多：茵陈头部：藁本；腰背：杜仲；上肢：姜黄；下肢：牛膝或木瓜；瘙痒：白鲜皮、地肤子、苦参2. 湿盛型：厚朴9、陈皮6、泽泻9、黄柏9、茯苓9、猪苓9、枳壳9、薏米9白术9、车前子9 湿重：苍术 顽症方：全虫（全蝎）6、皂角6、皂刺12、黄柏9、枳壳9、 苦参6、白鲜皮15、威灵仙12、生槐花15Dr
18、Zhao Bingnans Experience in Managing Eczema赵炳南治疗湿疹经验赵炳南治疗湿疹经验湿热血燥，脾虚湿停内治：分三型1.湿热互结，热重于湿：清热除湿：生石膏、山栀、黄芩、龙胆草凉血：生地、丹皮清热利水：车前草、车前子、冬瓜皮、马齿苋、六一散2.脾虚脾虚湿盛，湿蕴肌肤健脾除湿：白术、苍术、薏苡仁、枳壳、厚朴利水除湿：车前子、泽泻、茯苓皮、冬瓜皮、猪苓除湿止痒：马齿苋、苦参养血润肤：当归、丹参、赤芍3.阴虚血燥，气血瘀滞育因滋燥：熟地、天麦冬、女贞子、旱莲草、元参养血润肤：当归、赤白芍、桃仁、红花、丹参、首乌除湿止痒：白鲜皮、泽泻、茯苓、苦参 Dr Zhang
19、Zhilis Experience in Managing Eczema张志礼治疗湿疹经验张志礼治疗湿疹经验Dr. Gan Zhuwangs Experience干祖望祛湿清热经验方干祖望祛湿清热经验方 苍术：苍术：燥湿燥湿Cang Zhu: eliminating dampness黄柏：黄柏：清热清热Huang Bai: clearing heat忍冬藤：忍冬藤： 祛风祛风Ren Dong Teng: dispelling wind薄荷：薄荷：宣表宣表Be He: diffusing exterior牡丹皮：牡丹皮： 活血活血Mu Dan Pi: promoting blood circulation* A clinical trial of this formula was done in Hong Kong Basic Formula for Eczema in Children儿童湿疹基本方儿童湿疹基本方Case Analysis on TCM Management中医药和针灸治疗病例介绍中医药和针灸治疗病例介绍
