本文選題：白癜風 + 白駁湯�。� 參考：《中國人民解放軍軍醫(yī)進修學院》2008年博士論文

【摘要】： 蔡瑞康教授從事中西醫(yī)結合皮膚科臨床工作50余載,勤求古訓,博采眾長,立法遣方,靈活善用,積累了豐富的臨床經驗。他在臨床工作中結合現(xiàn)代醫(yī)學進畏,將中醫(yī)與西醫(yī)兩種診療體系有機結合,提出了皮膚病中醫(yī)辨證與西醫(yī)辨病相結合的診治理論,中西醫(yī)結合治療白癜風、皮炎、濕疹、銀屑病、痤瘡等常見的皮膚病,效果顯著,享譽全國。 白癜風是一種臨床常見的慢性獲得性色素脫失性皮膚病,發(fā)病率1%～2%,治療方法雖多,但起效慢、療程長、治愈率低,是皮膚科頑癥之一。蔡教授認為本病的病因病機是由肝腎不足、氣血不和、氣滯血瘀所致;治法以滋補肝腎、調和氣血、活血化瘀為主,同時重視情志因素的致病作用,輔以疏肝理氣解郁藥物,精心研制出經驗專方“白駁湯”。本課題通過采用皮膚鏡、皮膚圖像分析系統(tǒng)、皮膚顏色測量儀等現(xiàn)代醫(yī)學觀測方法進行形態(tài)學觀察和客觀測量,研究導師白駁湯中醫(yī)西結合治療白癜風的臨床療效及辨治思想。結果證實,結果證實,(1)白駁湯中西醫(yī)結合組起效快,各時間段總體療效均明顯優(yōu)于單純西醫(yī)治療組,并且隨治療時間的增加白駁湯方顯示了更佳的療效;(2)兩組白斑的色素恢復的過程都是漸進的,療效與治療時間的程正相關性,說明對于白癜風這種慢性難治性皮膚病,應強調堅持連續(xù)治療的重要性,療程長是該病的治療特征之一;(3)療效觀測指標可以量化,比以往的臨床單純感官判斷更加敏感和客觀。皮膚鏡及圖像分析技術可觀察到毛囊周圍出現(xiàn)的色素點和毛細血管充血擴張等白斑早期復色跡象;(4)白癜風發(fā)病和加重與精神因素密切在本次研究中得到證實,讓患者及時了解到療效進步,并在中醫(yī)理論指導下輔以疏肝理氣解郁調治,有助于減輕患者精神壓力、增加治療信心、配合醫(yī)生完成治療,進而提高總體療效。本課題還通過對門診120例白癜風患者進行心理問卷調查、心理干預和分組檢驗,目的是判斷心理干預在白癜風治療中的作用。結果表明,心理干預治療對于白癜風治療確有輔助增加療效的作用,并有助于提高療效和患者的生活質量。 本人在攻讀中醫(yī)師承制博士學位期間,經蔡教授悉心指導,系統(tǒng)地學習了皮膚病治療的中西醫(yī)理論,跟師參加臨床實踐,切身體會到導師的高尚醫(yī)德和勤奮鉆研精神;感悟到中西合璧、融會貫通、開拓進取,走中西醫(yī)結合之路是其皮膚病治療的學術特點和靈魂。在本課題的設計、實施、總結等全過程中,導師言傳身教,嚴格要求,使我在中西醫(yī)結合在專業(yè)理論水平和實際運用能力方面獲得巨大的進步,今后將更加自覺地學習和繼承導師累積的豐富臨床經驗,為祖國中西醫(yī)結合治療皮膚病事業(yè)做出貢獻。
[Abstract]:Professor Cai Ruikang is engaged in the clinical work of integrated traditional Chinese and western medicine for more than 50 years. He has accumulated rich clinical experience. In his clinical work, he combined modern medicine with modern medicine and organically combined the two systems of diagnosis and treatment of traditional Chinese medicine and western medicine, and put forward the theory of diagnosis and treatment of skin diseases based on TCM differentiation of symptoms and signs and differentiation of diseases in western medicine. The treatment of vitiligo, dermatitis, eczema with combination of traditional Chinese and western medicine, Psoriasis, acne and other common skin diseases, remarkable effect, renowned throughout the country. Vitiligo is a common chronic acquired pigment loss dermatosis. The incidence of vitiligo is 1 and 2. Although there are many methods of treatment, the course of treatment is slow, the course of treatment is long, and the cure rate is low. It is one of the intractable dermatological diseases. Professor Cai believes that the etiology and pathogenesis of this disease are caused by deficiency of liver and kidney, disharmony between qi and blood, and stagnation of qi and blood stasis. The treatment is mainly by nourishing the liver and kidney, harmonizing qi and blood, activating blood circulation and removing blood stasis. At the same time, he attaches importance to the pathogenicity of emotional factors and adjusts drugs to soothe liver and regulate qi and relieve depression. Carefully develop the experience of the special prescription, "White Mottage Tang". By using modern medical observation methods such as dermoscope, skin image analysis system and skin color measuring instrument, this paper studies the clinical curative effect and the thinking of differentiation and treatment of vitiligo treated by the combination of traditional Chinese medicine and western medicine. The results showed that the effect of the combined traditional Chinese and western medicine group was faster, and the overall curative effect of each time period was obviously better than that of the pure western medicine treatment group. And with the increase of the time of treatment, the decoction shows a better curative effect.) the process of pigment recovery of the two groups of white spots is gradual, and the effect is positively correlated with the duration of treatment, which shows that the treatment of vitiligo is a chronic and refractory skin disease. It should be emphasized that the importance of continuous treatment should be emphasized. The long course of treatment is one of the characteristics of the treatment of the disease. The observation index of curative effect can be quantified, and it is more sensitive and objective than the clinical simple sensory judgment in the past. Dermoscopy and image analysis techniques can be used to observe pigment spots around hair follicles and signs of early coloration of white spots, such as hyperemia and dilation of capillaries. (4) Vitiligo is closely related to mental factors and the pathogenesis and aggravation of vitiligo is confirmed in this study. It is helpful to lighten the patients' mental pressure, increase their confidence in the treatment, cooperate with the doctors to complete the treatment, and then improve the overall curative effect under the guidance of the theory of traditional Chinese medicine. The purpose of this study was to judge the role of psychological intervention in the treatment of vitiligo by psychological questionnaire, psychological intervention and group test in 120 patients with vitiligo. The results showed that psychological intervention could increase the curative effect and improve the quality of life of patients with vitiligo. During my study of doctor of Chinese medicine, I studied the theory of traditional Chinese medicine and western medicine systematically under the guidance of professor Cai, and took part in clinical practice with my teacher. I experienced the noble medical ethics and diligent research spirit of my mentor. It is the academic characteristic and soul of skin disease treatment to realize the combination of Chinese and western medicine, to integrate Chinese and western medicine, to forge ahead and to take the road of integration of traditional Chinese and western medicine. In the whole process of designing, implementing and summing up this subject, my tutor has made great progress in the professional theory level and practical application ability of integrating traditional Chinese and Western medicine with strict requirements. In the future, we will learn more consciously and inherit the rich clinical experience accumulated by our mentors, and contribute to the cause of integrated traditional Chinese and western medicine in the treatment of skin diseases.
【學位授予單位】：中國人民解放軍軍醫(yī)進修學院
【學位級別】：博士
【學位授予年份】：2008
【分類號】：R758.410.58;R249

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