【摘要】 掌跖脓疱病是皮肤科临床治疗的难点。文章基于《素问·太阴阳明论》“伤于湿者,下先受之”理论,结合该病好发掌跖的解剖特点及临床表现,重新审视掌跖脓疱病的病因病机及辨治方法。提出湿邪是掌跖脓疱病的关键病因,湿性下趋,郁滞手足,可胶结风、热、寒、瘀诸邪形成不同病机及证型;发作期以风寒湿热搏结肌肤为主,症见水肿浸润性红斑基础上新发深在性簇集性脓疱、渗出色黄黏稠,以麻黄连翘赤小豆汤合薏苡附子败酱散发表清里,祛湿排脓;缓解期以阴虚湿伏为要,症见皮肤干燥皲裂、角化脱屑,或伴散在脓疱,宜五苓散合潜阳封髓丹通阳化湿,引火归元;为中医诊治掌跖脓疱病提供新的理论依据和实践参考。更多还原

【Abstract】 Palmoplantar pustulosis(PPP) represents a challenging condition in the clinical management of dermatological disorders.Based on the theory ’dampness injury afflicts the lower body first’ from Suwen·Taiyin Yangming Lun,and in combination with the anatomical characteristics and clinical manifestations of the disease’ s predilection for the palms and soles,this article has re-examined the etiology,pathogenesis and treatment methods of PPP.Dampness pathogen was established as the pivotal etiological factor.The inherent descending tendency of dampness leads to stagnation in extremities,where it synergistically interacts with wind,heat,cold,and blood stasis pathogens,thereby generating diverse pathogenesis and differentiation patterns.During acute phases,the condition manifests as clustered deep-seated pustules on edematous erythematous bases with yellow viscous exudate,attributable to wind-cold-damp-heat entanglement.The combined use of Mahuang Lianqiao Chixiaodou Decoction and Yiyi Fuzi Baijiang Powder aimed to dispel external pathogens,clear internal dampness,and expel pus.In remission phases,characterized by xerotic fissures,hyperkeratosis,or scattered pustules due to yin deficiency with latent dampness,Wuling Powder combined with Qianyang Fengsui Pills was recommended to activate yang,resolve dampness,and guide floating fire back to its origin.This study provides novel theoretical foundations and practical references for traditional Chinese medicine management of this condition.更多还原