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Western Diagnosis & TCM Management for Common Skin Diseases 常见皮肤病的西医诊断和中医治疗 Yong Ming Li, MD, PhD

Western Diagnosis & TCM Management for Common Skin Diseases 常见皮肤病的西医诊断和中医治疗 Yong Ming Li, MD, PhD 李永明 博士 医师. Why an acupuncturist need to know skin diseases ？ 针灸医生为什么需要皮肤疾病？. 针灸医生最常见的疾病是什么？ 答案不是经常治疗的疼痛或抑郁 症，而是皮肤病。 针灸医生在“寻经取穴”时可以“顺便” 检查患者的皮肤病变 ，这 是其它科医生没有的方便条件。

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Western Diagnosis & TCM Management for Common Skin Diseases 常见皮肤病的西医诊断和中医治疗 Yong Ming Li, MD, PhD

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  1. Western Diagnosis & TCM Management for Common Skin Diseases 常见皮肤病的西医诊断和中医治疗 Yong Ming Li, MD, PhD 李永明 博士 医师

  2. Why an acupuncturist need to know skin diseases？ 针灸医生为什么需要皮肤疾病？ • 针灸医生最常见的疾病是什么？答案不是经常治疗的疼痛或抑郁症，而是皮肤病。 • 针灸医生在“寻经取穴”时可以“顺便”检查患者的皮肤病变，这是其它科医生没有的方便条件。 • 但是，很多针灸医生没有受过皮肤病诊断的训练，只好视而不见。 • 美国是个移民国家，不同种族的病人皮肤病种类繁多，尤其是白种人皮肤癌发病率极高，不及时诊断，可能危及生命。 • 针灸师如果能够掌握简单皮肤病诊断技能，对患者和提高行医水准都会十分有益。 • 中医中药和针灸在治疗一些炎症皮肤病和某些疑难皮肤病有很多优势，每位中医师和针灸师都应该在临床上探索使用。

  3. Why an acupuncturist need to know skin diseases？ 针灸医生为什么需要皮肤疾病？ • What is the most common condition encountered by an acupuncturist? The answer is not pain or depression but the skin problem. • While locating acupoints, an acupuncturist has the advantage to review most skin lesions, but other specialists do not have. • Unfortunately, many practitioners who have insufficient dermatological training choose to ignore skin problems. • Various complicated skin diseases might be seen in the USA and light skin individuals are special prone to skin cancer. • An acupuncturist with basic dermatological expertise can be a great benefit to patients as well as to his/her own practice. • Acupuncture and TCM herbs are known to be good alternative options for certain skin diseases.

  4. Western Diagnosis & TCM Management for Common Skin Diseases 常见皮肤病的西医诊断和中医治疗 1. 美国最常见皮肤病的分类2. 皮肤恶性肿瘤的临床特征和鉴别诊断3. 常见炎症皮肤病的分类和适合中医治疗的病症4. “望闻问切”在皮肤病诊断和鉴别诊断中的应用5. 中医药和针灸治疗病例介绍 1. The classification of commonly seen skin diseases in the USA 2. Clinical features and diagnosis of malignant skin tumors Commonly seen inflammatory skin diseases and conditions may be managed by TCM therapies Application of TCM diagnostic principles in the examination and screening of skin diseases 5. Case analysis on TCM management

  5. Classification of common skin conditions 常见皮肤病分类

  6. Common non-inflammatory skin conditions 常见非炎症皮肤病变 Seborrheic keratosis (SK) 脂溢性角化病Melanocytic nevus (mole) 黑色素痣Solar keratosis (actinic keratosis) 日光性角化病Fibroepithelial polyp (skin tag) 纤维上皮息肉Epidermal cyst (sebaceous cyst） 表皮囊肿Verruca vulgaris, condyloma (wart) 寻常疣，湿疣Dermal scar (keloid) 皮肤疤痕，瘢痕疙瘩Dermatofibroma 皮肤纤维瘤Neurofibroma 纤维神经瘤Hemangioma 血管瘤Basal cell carcinoma (BCC) 基底细胞癌Squamous cell carcinoma (SCC) 鳞状细胞癌Malignant melanoma (melanoma) 恶性黑素瘤

  7. Clinical Features and Diagnosis of Malignant Skin Tumors 皮肤恶性肿瘤的临床特征和鉴别诊断 Basal cell carcinoma (BCC) 基底细胞癌 Squamous cell carcinoma (SCC) 鳞状细胞癌 Malignant melanoma (melanoma) 恶性黑素瘤 Lymphoma, leukemia 淋巴瘤，白血病 Soft tissue malignant tumor 软组织恶性肿瘤 Metastatic cancer 转移癌

  8. Clinical Features of Malignant melanoma 恶性黑素瘤的临床特征

  9. Common inflammatory skin conditions 常见炎症皮肤病变 Eczema, atopic dermatitis 湿疹，特应性皮炎（异位皮炎）Allergic and contact dermatitis 过敏性和接触性皮炎Lichen simplex chronicus 神经性皮炎Acne 痤疮，粉刺Folliculitis 毛囊炎Herpes infection 疱疹病毒感染Drug reaction 药物皮炎Arthropod bite reaction 蚊虫叮咬Dermatophysis 皮癣Psoriasis 银屑癣，牛皮癣Lupus erythematosus 红斑狼疮Uticaria 荨麻疹Alopecia areata 斑秃

  10. Common Inflammatory Skin Diseases May Be Managed by TCM Therapies 常见炎症皮肤病的分类和适合中医治疗的病症 Eczema, atopic dermatitis 湿疹，特应性皮炎Allergic dermatitis 过敏性性皮炎Urticaria reaction 荨麻疹Zoster 带状疱疹Lichen simplex chronicus 神经性皮炎Psoriasis 银屑癣Auto immune dermatitis 自身免疫皮炎Alopecia 脱发Wart, verruca 疣Skin Itching, pain 皮肤瘙痒、疼痛

  11. Application of TCM Diagnostic Principles in the Examination and Screening of Skin Diseases “望闻问切”在皮肤病诊断和鉴别诊断中的应用 望：Inspection 闻：Listening & smelling 问：Inquiry 切：Palpation

  12. Tree Integrative Approaches in the Management of Eczema 中西医结合治疗湿疹的三中方法 • 中药 Herbs • 针灸 Acupuncture • 3. 生活和水土的改变 Life & Land Changes

  13. Acupuncture Points for Eczema Management 治疗湿疹的常用针灸穴位 神庭 Shen Ting 曲池 Qu Chi 合谷 He Gu 通里 Tong Li 阳陵泉 Yang Ling Quan 足三里 Zu San Li 隐白 Yin Bai 太冲 Tai Chong

  14. Acupuncture Shu Points for Eczema Management 治疗湿疹的常用针灸腧穴 定喘 Ding Chuan 风门 Feng Men 肺腧 Fei Shu 心腧 Xin Shu 脾腧 Pi Shu 胃腧 Wei Shu 三焦腧 San Jiao Shu 肾腧 Shen Shu

  15. Local Acupuncture Area for Eczema Management 治疗湿疹的局部针灸治区域

  16. Dr Zhu Renkang’s Experience in Managing Eczema 朱仁康治疗湿疹经验 • 重内因病表治里，祥外治殊途同归 内治：四型 1. 湿热：龙胆泻肝汤 龙胆草、黄芩、栀子、泽泻、 【木通】、 车前子、 当归、生地黄、柴胡、 甘草 脓疱：金银花、连翘；便干：大青叶 • 血热：皮癣汤加减 生地、丹皮、赤芍、黄芩、苦参、地肤子、白鲜皮、 丹参、生甘草

  17. Dr Zhu Renkang’s Experience in Managing Eczema 朱仁康治疗湿疹经验 内治： • 脾湿：胃苓汤加减 苍术、陈皮、茯苓、泽泻、六一散、白鲜皮 胃呆：藿香、佩兰；腹胀：川朴、大腹皮 • 阴伤：滋阴除湿法 生地、元参、当归、丹参、茯苓、泽泻、 白鲜皮、蛇床子 禁忌：重用燥湿和利湿之品

  18. Dr Zhu Renkang’s Experience in Managing Eczema 朱仁康治疗湿疹经验 外治： 1. 湿敷：急性期渗出 黄柏 或 马齿苋 或 生地榆 30克煎汁，用纱布浸透，外敷 • 药膏：各期均可以 湿疹膏等 • 粉剂：急性期 药粉加植物油：青黛、螵蛸、锻石膏、冰片

  19. Dr Zhao Bingnan’s Experience in Managing Eczema 赵炳南治疗湿疹经验 • 辨湿疹，要在湿热互结，治顽症用“全虫” 内治：二型 1. 热盛型： 龙胆草6、黄芩9、黄连6、泽泻9、 栀子6、 车前草15 生地黄15、连翘9、槐花9、 甘草3 【木通3】 便干：川军、枳壳；下焦湿热：黄柏；渗液多：茵陈 头部：藁本；腰背：杜仲；上肢：姜黄； 下肢：牛膝或木瓜；瘙痒：白鲜皮、地肤子、苦参 2. 湿盛型： 厚朴9、陈皮6、泽泻9、黄柏9、茯苓9、猪苓9、枳壳9、薏米9 白术9、车前子9 湿重：苍术 顽症方：全虫（全蝎）6、皂角6、皂刺12、黄柏9、枳壳9、 苦参6、白鲜皮15、威灵仙12、生槐花15

  20. Dr Zhang Zhili’s Experience in Managing Eczema 张志礼治疗湿疹经验 • 湿热血燥，脾虚湿停内治：分三型 • 湿热互结，热重于湿： 清热除湿：生石膏、山栀、黄芩、龙胆草 凉血：生地、丹皮 清热利水：车前草、车前子、冬瓜皮、马齿苋、六一散 • 脾虚脾虚湿盛，湿蕴肌肤 健脾除湿：白术、苍术、薏苡仁、枳壳、厚朴 利水除湿：车前子、泽泻、茯苓皮、冬瓜皮、猪苓 除湿止痒：马齿苋、苦参 养血润肤：当归、丹参、赤芍 • 阴虚血燥，气血瘀滞 育因滋燥：熟地、天麦冬、女贞子、旱莲草、元参 养血润肤：当归、赤白芍、桃仁、红花、丹参、首乌 除湿止痒：白鲜皮、泽泻、茯苓、苦参

  21. Dr. Gan Zhuwang’s Experience干祖望祛湿清热经验方

  22. Basic Formula for Eczema in Children 儿童湿疹基本方 苍术：燥湿 Cang Zhu: eliminating dampness 黄柏：清热 Huang Bai: clearing heat 忍冬藤：祛风 Ren Dong Teng: dispelling wind 薄荷：宣表 Be He: diffusing exterior 牡丹皮：活血 Mu Dan Pi: promoting blood circulation * A clinical trial of this formula was done in Hong Kong

  23. Case Analysis on TCM Management 中医药和针灸治疗病例介绍

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