| ObjectiveThe differentiation of six meridians in Treatise on febrile diseases not only has special effect on exogenous diseases,but also has important guiding value in the differentiation and treatment of difficult and miscellaneous syndromes.Professor Liu Min advocates the classics of traditional Chinese medicine,believes in the six meridians syndrome differentiation,has rich clinical experience,and is good at using classical prescriptions,which can also change the treatment of classical prescriptions.In practice,he is good at using classical prescriptions to treat various difficult diseases and syndromes,and has outstanding curative effect on skin diseases.Therefore,I hope to summarize and analyze the dialectical characteristics,ideas and prescriptions of the old teacher in using six meridians syndrome differentiation to treat skin diseases.MethodThis study is based on the research method of clinical literature research and retrospective study of clinical cases.In the first part,through the collection of literature and works related to the differentiation and treatment of six meridians,we completed the relevant review.In the second part,through the retrospective study of the collected clinical cases,the medical records and diagnosis and treatment information of Professor Liu Min in the Department of Endocrinology,the First Affiliated Hospital of Guangzhou University of traditional Chinese medicine from April 2018 to December 2019 were collected,and the standardized medical records,data management and database establishment were carried out,and then the relevant data were analyzed by using statistical methods combined with mathematical attribute partial order principle.The third part summarizes the treatment experience of six meridians differentiation and treatment of skin diseases,in order to further improve the law of six meridians differentiation and treatment of skin diseases.Results1.About six meridians differentiation and treatment of skin signsThe cases collected in this study include eczema,acne,urticaria and diabetic pruritus.In Taiyang syndrome,pruritus is often combined with red skin rash.It is also prone to skin rash scaling,skin erosion or dry skin,skin spots,red skin color,skin blisters,skin rashes such as prickles and other manifestations of damp heat and excessive heat.Most of the manifestations of Yangming syndrome are skin papules,which often appear together with dense rashes.Shaoyang syndrome is mostly characterized by red skin rash,which is often combined with skin rash and pruritus.Shaoyang syndrome is also prone to skin papule and skin rash fusing into lumps.The most common skin signs of Taiyin syndrome were skin ant sensation,followed by skin papule,red rash,pruritus and sparse rash.The most common skin sign of Shaoyin syndrome is skin papule,followed by red skin rash.In addition,skin rash often appears in Shaoyin syndrome.Most of the skin signs of Jueyin syndrome patients are characterized by skin ant sensation,which is often combined with skin rash,pruritus and rash.2.Aboutthe location of skin lesions treated by differentiation of six meridiansThe skin lesion location of skin disease is basically consistent with the meridian circulation.The syndrome of Taiyang meridian is mainly manifested in the limbs’ sun face,back,shoulder,waist and buttock;Yangming syndrome mainly manifested in the head and face;The syndrome of Shaoyang meridian is mainly manifested in the circulation of Shaoyang meridians on the face,flank and both sides of the body;The lesions of Sanyin syndrome were mainly located on the face and limbs,while those of Taiyin syndrome were mainly located on the Yin and face of limbs;Shaoyin syndrome is mainly manifested in the lower limb,face and chest;Jueyin syndrome is mainly manifested in pudenda,thigh root and face.3.About six meridians differentiation and treatment of skin diseases accompanied by cold,hot and sweating symptomsTaiyang syndrome has a very typical distribution of cold,hot and sweating symptoms,which is the same as the definition of Taiyang syndrome.It is often characterized by aversion to cold and wind.In addition,it also has mild heat symptoms.In terms of sweating symptoms,it is possible to have less or more sweat.The main manifestations of Yangming syndrome were sweating and sweating on the head.In Shaoyang syndrome,the manifestations of cold,heat and perspiration include aversion to cold,sweating and hand foot heart heat.The symptoms of hand foot heart heat with internal stagnation of fire and heat only appear in skin diseases of Shaoyang syndrome.Taiyin syndrome is characterized by cold abdomen,aversion to cold,cold limbs,and prone to spontaneous sweating.The main manifestations of Shaoyin syndrome are aversion to cold and cold limbs,as well as heart chest sweating and spontaneous sweating.Jueyin syndrome is characterized by febrile and cold abdomen,which reflects the nature of Jueyin syndrome.4.Pain symptoms associated with dermatosis treated by six meridiansIn the accompanying symptoms of skin diseases,there are few accompanying symptoms of pain,and if there are any,they are often consistent with the meridian circulation of the meridian.The mechanism of itching and pain of skin diseases is also mentioned in this research literature.There are overlaps in the excited areas of the brain,and it can also be seen that the lesions and pain symptoms are easily consistent with the meridian circulation.5.About the taste symptoms of skin diseases associated with the treatment of six meridiansThe symptoms of dry mouth and thirst can be seen in the six meridians of skin diseases,which indicates that skin diseases are related to the loss of body fluid.Yang syndrome is prone to thirst for cold drink,Yin Syndrome is prone to thirst for hot drink,and Shaoyang syndrome has typical symptoms of bitter mouth.6.Mental and emotional sleep symptoms associated with dermatosis treated by six meridiansThe symptoms of insomnia can be seen in the six meridians of skin diseases.Besides insomnia,Taiyang syndrome is easy to wake up in sleep.Yangming syndrome has obvious emotional symptoms which are easy to be upset,and also has symptoms of salivation during sleep and easy to wake up during sleep.Shaoyang syndrome has the most emotional symptoms,including anxiety,sighing,impatience and irritability,as well as more dreams in sleep.Three Yin Syndrome is easy to wake up and difficult to fall asleep,less Yin Syndrome is easy to have mental fatigue and more dreams,Jueyin syndrome is easy to have more dreams and more frightening symptoms.7.On the six meridians differentiation and treatment of skin diseases accompanied by systemic discomfortAmong the systemic symptoms,physical fatigue is the most frequent symptom of systemic discomfort in the six meridians.In addition to the fact that the medical records are collected in Guangdong,the physique is easily affected by the climate and environment,combined with the dry mouth in the front,it can be seen that the body fluid consumption and water metabolism function of skin patients are not good.In other aspects,Shaoyang syndrome is easy to be accompanied by dizziness,Yangming syndrome and Taiyin syndrome are easy to be accompanied by abdominal distension,Taiyin syndrome is also easy to have the performance of lower limb heaviness,Shaoyin syndrome is easy to be accompanied by lumbar acid,Jueyin syndrome is easy to be accompanied by heavy heart and chest distension.8.Eye,ear,nose and throat symptoms associated with dermatosis treated by six meridiansIn the accompanying symptoms of eye,ear,nose and throat,skin disease only Shaoyang syndrome often accompanied with eye,ear,nose and throat symptoms,and among them,pharyngeal blockage is the most common symptom,followed by dry throat symptoms,dry throat symptoms and Shaoyang syndrome defined symptoms consistent.9.About the sound and odor symptoms associated with the six meridians differentiation and treatment of skin diseasesFrom the accompanying sound and odor symptoms,we can find that Taiyang syndrome is easy to be accompanied by cough and asthma,while Yangming syndrome is easy to have bad breath and more sagittal Qi,Taiyin syndrome is easy to have belching and more sagittal Qi,so we can see that Taiyang syndrome is easy to be accompanied by exogenous and pulmonary diseases,while Yangming syndrome and Taiyin syndrome are easy to be accompanied by gastrointestinal problems.10.On the treatment of the symptoms of defecation and urination associated with skin diseases through the six meridiansAmong the two stool symptoms associated with skin diseases,abnormal defecation is more common,and abnormal urination is relatively rare,especially in Taiyang syndrome and Shaoyang syndrome.Taiyang syndrome is often accompanied by loose or dry stool and yellow urine;Yangming syndrome is often accompanied by dry stool or diarrhea,etc;Shaoyang syndrome is often accompanied by loose stool and yellow urine;Taiyin syndrome and Shaoyin syndrome are mostly accompanied by loose stool,Taiyin syndrome is mostly accompanied by blistering urine,Shaoyin syndrome is mostly accompanied by polyuria and nocturia;Jueyin syndrome is often accompanied by constipation and sparse stool.11.About the treatment of male and female symptoms associated with dermatosis by six meridiansNo male symptoms were found in the medical records collected in this study,and only female symptoms were found in the two meridians of Shaoyang and Shaoyin.The more common symptoms were blood clot and abdominal pain.Shaoyin syndrome is also easy to have the symptoms of menstrual low back acid,followed by pre menstrual milk distension,less menstrual volume and light menstrual blood color;the most common symptom of Shaoyang syndrome is menstrual blood block,followed by abdominal pain,dark red menstrual color and pre menstrual milk distension,in addition,there are more symptoms of leucorrhea of Shaoyang syndrome.12.Prescriptions and traditional Chinese medicine commonly used by Professor Liu Min.Guizhi,Zhigancao,jujube,red peony,bitter almond and ephedra are commonly used in Taiyang syndrome.According to the principle of attribute partial order structure,Guizhi is often combined with Zhigancao,jujube and red peony to form Guizhi formula,and also combined with Zhigancao,jujube,red peony,bitter almond and ephedra to form Mahuang formula.The commonly used traditional Chinese medicines for Yangming syndrome are Radix Glycyrrhizae,Radix Scutellariae,Rhizoma Coptidis,radix puerariae,radix paeoniae rubra,cortex moutan and poria cocos.According to the principle of attribute partial order structure,they are often combined into modified Gegen Qinlian decoction.Chaihu,Huangqin,Zhigancao,Dazao,Guizhi,Chishao and Hongshen are commonly used in Shaoyang syndrome.According to the principle of attribute partial order structure,Chaihu prescriptions are often composed of Chishao,Guizhi,Dazao,Chaihu,Huangqin,Fabanxia,Hongshen and dangshen.According to the principle of attribute partial order structure,Fuzi is often combined with dried ginger,fried licorice,red ginseng and Atractylodes macrocephala to form Fuzi Lizhong decoction.According to the principle of attribute partial order structure,Fuzi is often combined with oyster,dragon bone and dried ginger,and is often combined with Poria cocos,red peony root,red ginseng and Astragalus membranaceus to form Fuling Sini Decoction and Zhenwu decoction.According to the principle of attribute partial order structure,Cortex Phellodendri,Rhizoma Coptidis,Cortex Phellodendri,Fructus Mume,Codonopsis pilosula,Radix zanthoxyli,Radix Aconiti Lateralis Preparata,Radix Aconiti Lateralis Preparata,Rhizoma Coptidis,Radix Angelicae sinensis,Radix Codonopsis pilosula and Radix zanthoxyli are often used together to form the Wumei decoction.ConclusionThe common skin signs of Taiyang syndrome include rash,pruritus,skin rash and red skin rash.The lesion site is often consistent with the circulation of Taiyang meridians.The typical symptoms are outline syndrome of Taiyang syndrome,accompanied by dry mouth,thirst,thirst for cold drinks,insomnia and respiratory symptoms.The core pathogenesis is disharmony between Ying and Wei.Guizhi prescriptions are commonly used for treatment.The common skin signs of Yangming syndrome are skin papules with dense rashes.The lesions are common on the head and face.The typical symptoms are abdominal pain,dry stool or diarrhea,incomplete grain,excessive sagittal Qi and bad breath.The accompanying symptoms are sweating,sweating,thirsty drinking,upset,insomnia and salivation during sleep.The core pathogenesis of Yangming syndrome is excessive heat and damp heat,The commonly used prescription is Gegen Qinlian decoction.The common skin signs of Shaoyang syndrome are red rash,rash and pruritus.The lesions are often located in the Shaoyang meridians on both sides of the body.The typical symptoms include bitter mouth,dry throat,throat blockage,dizziness,blurred vision and nausea.The accompanying symptoms include abdominal pain,migraine,hypochondriac pain,upset,anxiety,impatience,irritability,dark menstrual color,menstrual blood clot The core pathogenesis of abdominal pain,premenstrual breast distension and hypomenorrhea is the disadvantage of Shaoyang axis,and the commonly used prescriptions are Chaihu.The common skin sign of Taiyin syndrome is the feeling of ants on the skin.The skin lesions are mainly on the Yin and face of the limbs.The typical symptoms are aversion to cold,cold limbs,abdominal cold,abdominal pain,abdominal distension,belching,more sagittal Qi,loose stool and thin stool.The accompanying symptoms are heavy legs,dry mouth,thirsty for hot drink,spontaneous sweating and sweating.The core pathogenesis is spleen deficiency and cold dampness.Fuzi Lizhong decoction is often used for treatment.The common skin signs of Shaoyin syndrome include skin papules,red skin rash,ant sensation on the skin,and rash scratch.The lesions are distributed on the face,lower limbs,the whole body,and chest.The typical symptoms are chilly,cold limbs,mental fatigue,and sleepiness.The accompanying symptoms are low back pain,low back pain,polyuria,nocturia,low back pain during menstruation,less menstruation,and pale blood color.The core pathogenesis is Yang deficiency of heart and kidney,It is often treated with Zhenwu decoction.The common skin signs of Jueyin syndrome are skin ant feeling,skin rash itching and skin rash.The skin lesions are common in pudenda,thigh root and face.The typical symptoms are five heart upset and hot,heavy heart,chest distension and tightness,and abdominal cold.The accompanying symptoms are abdominal pain,sweating,Glossalgia,insomnia,difficulty in waking up at night,dreaminess and panic.The core pathogenesis is mixed cold and heat,which is often treated with Wumei Pill.Through the above summary of six meridians syndrome differentiation and treatment of skin diseases,it can be found that there are obvious differences between three yang and three yin syndromes in some symptoms.Therefore,in the diagnosis of skin diseases,we should first distinguish Yin and Yang,then determine the six meridians,and then investigate according to the symptoms,in which the lesion site has an important role in prompting,and finally confirm the six meridians classification of skin diseases.Professor Liu Min’s syndrome differentiation and treatment of skin diseases,first identify the type of six meridians,and then choose the prescription,and then add and subtract with the disease.Professor Liu Min often uses Chaihu Guizhi Decoction in the treatment of skin diseases,and also uses classic prescriptions in combination with time prescriptions,such as Fuzi decoction,Zhenwu decoction combined with Fengsui pill,Lizhong decoction combined with Yiqi Congming decoction,etc.In addition,the treatment of skin diseases also pay attention to regulating blood,often using Siwu Decoction,such as Siwu Decoction,Danggui Yinzi,Taohong Siwu Decoction,or combined with Huoxue Huayu drugs,such as Danshen,Sanleng,zedoary,etc.Also often accompanied by antipruritic drugs,such as Schizonepeta tenuifolia,Fangfeng,etc.Professor Liu Min also pays attention to sleep problems in the treatment of skin diseases,and uses tranquilizing drugs,such as adding sour jujube kernel,keel,oyster and so on.Finally,the classical prescriptions used by Professor Liu Min in the treatment of skin are summarized,among which the most commonly used prescriptions are Guizhi,Mahuang,Chaihu and Fuzi.This paper summarizes Professor Liu Min’s clinical thinking and prescription characteristics of six meridians syndrome differentiation and treatment of skin diseases,which is conducive to the promotion of the experience of six meridians syndrome differentiation and treatment of skin diseases,so that TCM students can learn and understand how to treat skin diseases with six meridians syndrome differentiation and treatment,and can better serve the clinical treatment of skin diseases. |
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