常见皮肤病的西医诊断和中医治疗.ppt

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,Western Diagnosis&TCM Management,for Common Skin Diseases,常见皮肤病的西医诊断和中医治疗,Yong Ming Li,MD,PhD,李永明 博士 医师,针灸医生最常见的疾病是什么？答案不是常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，这是其他科医生没有的以便条件。,不过，诸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，不一样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，也许危及生命。,针灸师假如可以掌握简朴皮肤病诊断技能，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某些炎症皮肤病和某些疑难皮肤病有诸多优势，每位中医师和针灸师都应当在临床上探索使用。,Why an acupuncturist need to know skin diseases？,针灸医生为何需要皮肤疾病？,Why an acupuncturist need to know skin diseases？,针灸医生为何需要皮肤疾病？,What is the most common condition encountered by an acupuncturist?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.,Various 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 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性和鉴别诊断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简介,1.The classification of commonly seen skin diseases in the USA,2.Clinical features and diagnosis of malignant skin tumors,Commonly seen inflammatory skin diseases and conditions may,be managed by TCM therapies,Application of TCM diagnostic principles in the examination and,screening of skin diseases,5.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,Classification of common skin conditions,常见皮肤病分类,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,Dermatofibroma,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,Clinical Features and Diagnosis of Malignant Skin Tumors,皮肤恶性肿瘤的临床特性和鉴别诊断,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,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性,Eczema,atopic dermatitis,湿疹，特应性皮炎（异位皮炎）,Allergic and contact dermatitis,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,Eczema,atopic dermatitis,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,Application of TCM Diagnostic Principles in the Examination and Screening of Skin Diseases,“望闻问切”在皮肤病诊断和鉴别诊断中的应用,望：,Inspection,闻：,Listening&smelling,问：,Inquiry,切：,Palpation,Tree Integrative Approaches in the Management of Eczema,中西医结合治疗湿疹的三中措施,中药 Herbs,针灸 Acupuncture,3.生活和水土的变化 Life&Land Changes,Acupuncture Points for Eczema Management,治疗湿疹的常用针灸穴位,神庭,Shen Ting,曲池,Qu Chi,通里,Tong Li,合谷,He Gu,阳陵泉,Yang Ling Quan,隐白,Yin Bai,足三里,Zu San Li,太冲,Tai Chong,Acupuncture Shu Points for Eczema Management,治疗湿疹的常用针灸腧穴,风门,Feng Men,肺腧,Fei Shu,心腧,Xin Shu,脾腧,Pi Shu,胃腧,Wei Shu,三焦腧,San Jiao Shu,肾腧,Shen Shu,定喘,Ding Chuan,Local Acupuncture Area for Eczema Management,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,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 in Managing Eczema,朱仁康治疗湿疹经验,内治：,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,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,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,药膏：各期均可以,湿疹膏等,粉剂：急性期,药粉加植物油：青黛、螵蛸、锻石膏、冰片,Dr Zhu Renkangs Experience in Managing Eczema,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,15,Dr Zhao Bingnans Experience in Managing Eczema,赵炳南治疗湿疹经验,湿热血燥，脾虚湿停,内治：分三型,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,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,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 Zhilis Experience in Managing Eczema,张志礼治疗湿疹经验,Dr.Gan Zhuwangs Experience,干祖望祛湿清热经验方,苍术：,燥湿,Cang Zhu:,eliminating dampness,黄柏：,清热,Huang Bai:,clearing heat,忍冬藤：,祛风,Ren Dong Teng:,dispelling wind,薄荷：,宣表,Be He:,diffusing exterior,牡丹皮：,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,小朋友湿疹基本方,Case Analysis on TCM Management,中医药和针灸治疗病例简介,