中醫對牛皮癬(銀屑病)病因病機的認識

(1)風邪阻於肌表
中醫對銀屑病病因最早的認識是風邪客於皮膚,且多為風挾濕。古人認為風濕之邪阻於肌表,影響肌表氣血的運行,肌膚失養而乾燥,則會發生銀屑病。從現代醫學解讀,是外在的環境因素引致病的發生,風邪既指氣候因素,又指微生物因素,與現代研究提到的潮濕的環境與微生物感染不謀而合。
(2)血熱蘊鬱肌膚
到金元、明清時期,在“火熱論”學派的影響下,中醫認識到熱邪在銀屑病發病中的作用,提到風邪挾熱、挾毒。到現代,諸多名醫更明確提到血熱是白疕的主要病因。血熱蘊鬱肌膚,故皮損表現紅斑成塊,或全身潮紅呈紅皮症;熱灼津液,故皮損乾燥脫屑或鱗屑厚積。
血熱常由下列因素導致:風寒、風熱之邪入裡化熱;情志不暢,鬱久化熱;脾胃損傷,飲食鬱積化熱。
(3)血虛血燥不榮肌表
銀屑病的發生既有外來的風邪因素,又有出自於體內的因素——血虛血燥,因為血虛不能榮養肌膚,而致白疕皮損表現乾燥脫屑。在中醫文獻中,凡因血虛不夠營養人體五臟六腑、五官七竅和皮膚而導致乾燥的病理現象都稱之為血燥。現代中醫名家又在血燥的基礎上提出肝腎陰虛不能榮養肌膚也可導致白疕。血虛血燥常見為素體虛弱、氣血不足或病久耗傷營血,陰血虧虛,生風化燥而致。

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