慢性湿疹须重视调治脾胃 Chronic Eczema Should Be Treated with More Attention to The Rehabilitation of Spleen and
本人通过对湿疹病人的观察发现，近九成的湿疹病人脾虚，脾胃不和，这从中医角度解释了慢性湿疹病人之所以容易复发的原因，即脾虚导致代谢后身体的水液不能正常排出体外，易溢于皮肤而引发湿疹。
造成湿疹的原因是多元化的，工作节奏快、生活作息不规律、饮食失常等导致身体的免疫功能下降，成为湿疹的元凶。中医认为诱发湿疹的主要原因是湿热内蕴。正常情况下，人体内的湿热是通过脾的运化功能排出体外，但是在脾胃功能虚弱的情况下，对湿热的运化和排泄能力也会随之下降，长期以往，不易排出的湿邪就可能会诱发湿疹。
有脾虚的湿疹患者是不容易痊愈的，多数情况下湿疹到后期都会演变为慢性湿疹，主要表现为皮肤粗糙、肥厚、干燥。一般情况下，脾具有运化水谷精微的能力，能够把人体摄入的五谷杂粮运化为气血滋养皮肤。但是在脾虚的情况下，脾的运化能力差直接导致皮肤无法正常修复，慢性湿疹的症状不容易改善。
从另一方面来说，目前临床表现的湿疹多是慢性湿疹，整个治疗过程中会不可避免地摄入大量药物，而很多药物本身对脾胃是有损伤的，这会在一定程度上造成患者脾虚，从而导致病情难愈。因此，这也提示湿疹病人在治疗的过程中不单要治疗湿疹，也要注意调理脾胃。
湿疹治疗的一般临床路径是控制和调理双管齐下，在急性期时以控制病情为主，等到病情控制后，改用慢性调理，尤其是调理脾胃。从临床效果来看，以控制和调理全方位治疗的湿疹病人，其复发的几率很小。
因此慢性湿疹病人一定要加强对脾胃的调理。比如注重饮食有常和起居有度，保持心情舒畅;辛酸辣的东西对皮肤有刺激性作用，贪凉多食冷饮都会使湿疹恶化，身居潮湿的环境也会有一定程度的影响;注意多吃蔬菜、粗粮(用薏仁米、山药、红豆、莲子肉煮粥)均能在日常细节中起到健脾的作用。
李东垣在《脾胃论·脾胃盛衰论》中说：“百病皆由脾胃衰 而生也。 ”除了湿疹外，许多慢性、难治性皮肤病的病因病机都与脾胃功能 失调有着相当密切的关系。 如风瘙痒（包括老年性皮肤瘙痒症）、粉刺（痤疮），其治疗也要 以健中补脾，促进运化为基本方，牛皮癣治疗也要重视调理脾胃功能，祛湿化湿。
需要提醒的是，治疗湿疹千万不要盲目听信偏方自救，很多时候反而会对脾胃造成伤害，一定要在中医一师指导下进行正规的治疗。
Through my observation of eczema patients, I found that nearly 90 of eczema patients had spleen deficiency and the discordance from spleen and stomach, which explains why chronic eczema patients are prone to relapse in the perspective of traditional Chinese medicine .That is, the spleen deficiency caused by the metabolism of the body's fluid can not be normal discharged out of the body, prone to overflow in the skin and caused eczema.
The reason for eczema is that the body's immune function is weakened or unbalanced due to a variety of factors, such as the fast pace of work, the irregular routine of life, and eating disorders. In Chinese medicine, we believes that the main cause of eczema induced by excessive heat and damp accumulated in the body. Under normal circumstances, the human body's heat and damp is discharged from the body through the function of the spleen, but in the case of weak spleen and stomach function, the ability to transport and drain the damp and heat will also be reduced. It is possible to induce eczema when it is not easily discharged.
In most cases, eczema will develop into chronic eczema in the late period, mainly in expression of rough, thick and dry skin. Under normal circumstances, the spleen has the ability to transport the damp grains slightly, which can transport the human body's intake of food into energy and nutrition to blood to nourish the skin. However, in the case of spleen deficiency, the poor transport ability of spleen directly causes the skin to be unable to be nourished normally, and the symptoms of chronic eczema are not easy to improve.
On the other hand, at present, the clinical manifestations of eczema are mostly chronic eczema, and the whole treatment process will inevitably take in a large number of drugs, and many drugs themselves have side effect and damaged the function of spleen and stomach. This will cause the patient's spleen deficiency to a certain extent, thus causing the illness to be difficult to heal. Therefore, it also suggests that eczema patients should not only treat eczema, but also take care of their spleen and stomach.
The general clinical path of eczema treatment is a combination of treatments and rehabilitation. According to the clinical results, the risk of relapse is very small in patients with eczema treated in both directions.
Therefore, patients with chronic eczema must also pay attention to the rehabiliation of the spleen and stomach function. For example, pay attention to healthy eating, regular life pattern, and keeping a comfortable and unwind mood. Spicy and hot food have irritating effects on the skin, and greasy and cold foods will make eczema worse. Having a damp environment will also have a certain degree of influence; pay attention to eat more vegetables and coarse grains (like the porridge of glutinous rice, yam, red beans, lotus seeds etc) can play a healthy role in the spleen in daily meal.
In the "Spleen and Stomach Theory: The Theory of Spleen and Stomach Rise and Fall," Li Dongxi said: "All diseases are caused by spleen and stomach disfunction." In addition to eczema, the etiology and pathogenesis of many chronic, intractable skin diseases are closely related to spleen and stomach dysfunction. Such as wind itching (including senile pruritus), acne (acne), its treatment should also pay attention to rehabilate the spleen and stomach function in order to get rid of dampness and heat.
What needs to be reminded is that the treatment of eczema should not blindly use the folk remedies to save oneself, and often it will cause further harm to the spleen and stomach. It is always wise to seek advice from your GP and qualified Chinese Medicine practitioner.
Note: This article is translated by Ying Zhang BSc MBAcC . Please contact Ying Zhang if you have any question in regards to this translation.
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王秋兰 主任中医师
硕士毕业于南京中医药大学，曾经拜师于数名全国名老中医，搏采众长，参与编写（明清医学荟萃）等大部中医学著作，曾被评为南京市中青年拔尖人才及跨世纪人才，曾两次被江苏省政府选派到日本进行医学交流。擅长治疗妇科病，不孕不育，皮肤病，各种痛症，肝肾疾病等，国内外行医20余年来，积累了丰富的临床经验，治愈患者众多，深得病人的好评。
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