Urticaria is a common allergic disease, which is caused by the expansion of small blood vessels in skin and mucosa and the increase of osmotic pressure. Among them, repeated skin lesions are chronic urticaria, at least twice a week, lasting for more than 6 weeks, with intermittent attacks.
clinical picture
Recurrent wheal and severe itching affect the quality of life of patients;
Red or pale white air masses appear on the skin;
It occurs in loose parts such as eyelids and lips, and then it shows edema.
2. TCM knowledge of chronic urticaria.
Chronic urticaria is equivalent to "adult addiction rash" and "red and white wind" in traditional Chinese medicine. It was first seen in Su Wen that "less yin is more than enough, and the diseased skin is blocked."
The cause of disease
(1), the pace of life is fast, and the pressure of work and study is increasing.
(2), irregular diet, fat and sweet.
(3), clinical manifestations (liver and spleen damage) irritability, insomnia and dreaminess, anorexia and fatigue.
3. Liver and spleen and chronic urticaria
Liver and chronic urticaria
Hair has no fixed place, and suddenly it disappears. Wind evil: fickle several times.
Recurrent attacks, long course of disease. Internal wind: wind evil included.
All wind dizziness belongs to the liver.
The disharmony between qi and blood is the hinge of harmonizing liver qi and blood.
(1), the liver governs the release of qi.
Blood syndrome theory
"The liver belongs to wood, and the wood is rushing.
If you don't suppress depression, your blood will flow smoothly. "
(2), the liver governs the discharge-regulating emotions.
Su Wen ling LAN cheats
"Liver, the officer of the general, seeks."
(3) Liver governs storing blood
Lingshu itself
"The liver stores blood, and the blood gives up the soul."
(4), liver failure to drainage.
Qi stagnation-liver depression
Over time, the heat turned to anger.
Excessive heat leads to wind-liver wind
(5) Emotional disharmony
Important inducement of chronic urticaria
"Depressed and uncomfortable, this is a disease of liver wood."
(6) Liver does not store blood.
Skin dystrophy, blood deficiency leading to wind
"Cure the wind first, cure the blood, and the blood will come out."
Spleen and chronic urticaria
"Zhou Xian Cuoshu Pixie" "Pixie mostly belongs to the spleen, because the skin is dull and itchy, or red or not."
"The key to syndrome differentiation and treatment is Fadan." "Anyone who suffers from this disease, some people can't eat chicken or octopus for a lifetime, and then use Dan to send it, which shows that it is spleen wind."
Refractory dermatoses-damp pathogen, wet stickiness, prolonged course of disease, and all kinds of wet swelling all belong to the spleen.
Disharmony between qi and blood: spleen-the source of qi and blood biochemistry
Etiology: Dietary fatigue damages the spleen and stomach, emotional imbalance, seeing the disease of liver, knowing that the liver spreads to the spleen, overeating fat and sweet, and dampness and evil trapping the spleen.
Pathogenesis: Spleen is the source of qi and blood biochemistry. "Red-and-white swimming wind belongs to spleen and lung qi deficiency, and the principle is not dense, and wind and heat beat each other", which leads to weathering and dryness due to qi and blood deficiency. Spleen governs transport and transformation. Wet is endogenous, and heat is generated over time. Damp-heat injures yin, weathering and drying. Phlegm resolving type
4. Treating chronic urticaria from liver and spleen.
Jiawei antiallergic decoction
(1), soothing liver, nourishing blood and astringing yin: Bupleurum, ebony.
(2), spleen and dehumidification: Atractylodes macrocephala and Poria.
(3), clearing heat and promoting diuresis: Sophora flavescens, Dictamni Radicis, and winter melon skin.
(4) Dispelling wind and relieving itching: Radix Saposhnikoviae, Herba Schizonepetae, Xu Changqing and Luffa.
(5) Promoting blood circulation, nourishing blood and removing blood stasis: Radix Paeoniae Rubra, Radix Angelicae Sinensis, Rhizoma Chuanxiong and Caulis Spatholobi.
(6), nourishing the heart and calming the nerves: Albizia Albizia bark.
Regulating liver and spleen, clearing away heat and removing dampness, promoting blood circulation and dredging collaterals, expelling wind and relieving itching.
Pharmacological research, anti-inflammatory (Bupleurum, Poria, Radix Sophorae Flavescentis, Radix Saposhnikoviae, and Radix Angelicae Sinensis), antibacterial (Schizonepeta, Radix Saposhnikoviae, Radix Sophorae Flavescentis, and Radix Angelicae Sinensis), antiallergic (Cortex Albizziae, Mume, Xu Changqing, Radix Sophorae Flavescentis, and Cortex Dictamni Radicis), and immunomodulation (Bupleurum, Atractylodis Rhizoma, Poria, Radix Sophorae Flavescentis, Radix Saposhnikoviae, and
5. Typical cases
Patient Li, female, 43 years old, was first diagnosed on May 24th, 2065438.
Chief complaint: repeated rash on trunk with itching.
Current medical history: Half a year ago, due to busy work and heavy life pressure, skin blisters appeared on the trunk and I felt itchy. It was diagnosed as "urticaria" in dermatology departments of several hospitals, and loratadine, cetirizine, Chinese patent medicine and Chinese herbal medicine were taken orally. Symptoms are slightly relieved, but wheeze appears and disappears from time to time. Every time you work hard, work overtime and stay up late, it breaks out or gets worse, which affects patients' mood and reduces their quality of life.
Incision: skin rash on trunk, accompanied by itching, irritability, insomnia, dreaminess, anorexia, weakness of limbs and normal defecation.
Physical examination: trunk scattered in the wind, normal or white skin color, conscious itching, skin scratches. Red tongue with white fur and thin pulse.
In the past, he was in good health and had no medication history in recent weeks.
Laboratory examination: blood routine (-). Allergen detection: (-).
Western medicine diagnosis: chronic urticaria
Traditional Chinese medicine diagnosis: addiction rash, the syndrome belongs to liver depression and spleen deficiency.
Treatment: regulating liver and spleen, clearing heat and removing dampness, promoting blood circulation and dredging collaterals, expelling wind and relieving pain.
Prescription: Jiawei Anti-allergic Decoction
Bupleuri Radix, Mume Fructus, Atractylodis Rhizoma, Poria, Radix Paeoniae Rubra, Radix Angelicae Sinensis, Radix Sophorae Flavescentis, Cortex Dictamni Radicis, Radix Saposhnikoviae, Herba Schizonepetae, Rhizoma Chuanxiong, Xu Changqing, Luffa Fructus, pericarpium Benincasae, Cortex Albizziae and Caulis Spatholobi, one dose per day, half an hour after boiling water, twice in the morning and evening.
Follow-up visit: wheezing and itching are obviously relieved compared with before. Take the original formula 14.
Three diagnosis: all symptoms are cured and sleep safely at night.
Follow-up after three months showed no recurrence.
Warning: this prescription is only for Chinese medicine lovers to learn and discuss; Due to factors such as decocting Chinese herbal medicines and taboos, if you use this prescription privately, please consult local Chinese medicine practitioners for details.