WesternDiagnosis&TCMManagementforCommonSkinDiseases常見皮膚病的西醫(yī)診斷和中醫(yī)治療YongMingLi,MD,PhD李永明博士醫(yī)師常見皮膚病的西醫(yī)診斷和中醫(yī)治療課件 針灸醫(yī)生最常見的疾病是什么？答案不是經(jīng)常治療的疼痛或抑郁 癥，而是皮膚病。 針灸醫(yī)生在“尋經(jīng)取穴”時(shí)可以“順便”檢查患者的皮膚病變，這 是其它科醫(yī)生沒有的方便條件。

但是，很多針灸醫(yī)生沒有受過皮膚病診斷的訓(xùn)練，只好視而不見。

美國是個(gè)移民國家，不同種族的病人皮膚病種類繁多，尤其是白種

人皮膚癌發(fā)病率極高，不及時(shí)診斷，可能危及生命。

針灸師如果能夠掌握簡單皮膚病診斷技能，對患者和提高行醫(yī)水準(zhǔn)

都會(huì)十分有益。

中醫(yī)中藥和針灸在治療一些炎癥皮膚病和某些疑難皮膚病有很多優(yōu)

勢，每位中醫(yī)師和針灸師都應(yīng)該在臨床上探索使用。

Whyanacupuncturistneedtoknowskindiseases？針灸醫(yī)生為什么需要皮膚疾病？ 針灸醫(yī)生最常見的疾病是什么？答案不是經(jīng)常治療的疼痛或抑Whyanacupuncturistneedtoknowskindiseases？針灸醫(yī)生為什么需要皮膚疾?。?Whatisthemostcommonconditionencounteredbyan acupuncturist? Theanswerisnotpainordepressionbutthe skinproblem. Whilelocatingacupoints,anacupuncturisthastheadvantageto reviewmostskinlesions,butotherspecialistsdonothave. Unfortunately,manypractitionerswhohaveinsufficient dermatological trainingchoosetoignoreskinproblems. VariouscomplicatedskindiseasesmightbeseenintheUSA andlightskinindividualsarespecialpronetoskincancer. Anacupuncturistwithbasicdermatologicalexpertisecanbea greatbenefittopatientsaswellastohis/herownpractice. AcupunctureandTCMherbsareknowntobegoodalternative options forcertainskindiseases.Whyanacupuncturistneedtok1.美國最常見皮膚病的分類

2.皮膚惡性腫瘤的臨床特征和鑒別診斷

3.常見炎癥皮膚病的分類和適合中醫(yī)治療的病癥

4.“望聞問切”在皮膚病診斷和鑒別診斷中的應(yīng)用

5.中醫(yī)藥和針灸治療病例介紹1.TheclassificationofcommonlyseenskindiseasesintheUSA2.ClinicalfeaturesanddiagnosisofmalignantskintumorsCommonlyseeninflammatoryskindiseasesandconditionsmaybemanagedbyTCMtherapiesApplicationofTCMdiagnosticprinciplesintheexaminationandscreeningofskindiseases5.CaseanalysisonTCMmanagementWesternDiagnosis&TCMManagementforCommonSkinDiseases常見皮膚病的西醫(yī)診斷和中醫(yī)治療1.美國最常見皮膚病的分類

2.皮膚惡性腫瘤Classificationofcommonskinconditions常見皮膚病分類Skindiseases皮膚病變Non-inflammatory非炎癥Neoplasm腫瘤Benigntumor良性腫瘤Malignanttumor惡性腫瘤Non-neoplasm非腫瘤Physiologicalchange生理改變Pathologicalchanges病理改變Inflammatory炎癥Infection感染Virusinfection病毒感染Microorganisminfection菌類感染Non-infection非感染Autoimmune自身免疫Nonspecificinflammation非特異炎癥ClassificationofcommonskinSeborrheickeratosis(SK)脂溢性角化病

Melanocyticnevus(mole)黑色素痣

Solarkeratosis(actinickeratosis)日光性角化病

Fibroepithelialpolyp(skintag)纖維上皮息肉

Epidermalcyst(sebaceouscyst）表皮囊腫

Verrucavulgaris,condyloma(wart)尋常疣，濕疣

Dermalscar(keloid)皮膚疤痕，瘢痕疙瘩

Dermatofibroma皮膚纖維瘤

Neurofibroma纖維神經(jīng)瘤

Hemangioma血管瘤

Basalcellcarcinoma(BCC)基底細(xì)胞癌

Squamouscellcarcinoma(SCC)鱗狀細(xì)胞癌

Malignantmelanoma(melanoma)惡性黑素瘤Commonnon-inflammatoryskinconditions常見非炎癥皮膚病變Seborrheickeratosis(SK)脂溢ClinicalFeaturesandDiagnosisofMalignantSkinTumors皮膚惡性腫瘤的臨床特征和鑒別診斷Basalcellcarcinoma(BCC)基底細(xì)胞癌

Squamouscellcarcinoma(SCC)鱗狀細(xì)胞癌

Malignantmelanoma(melanoma)惡性黑素瘤Lymphoma,leukemia淋巴瘤，白血病Softtissuemalignanttumor軟組織惡性腫瘤Metastaticcancer轉(zhuǎn)移癌ClinicalFeaturesandDiagnosiClinicalFeaturesofMalignantmelanoma惡性黑素瘤的臨床特征ClinicalFeaturesofMalignantEczema,atopicdermatitis濕疹，特應(yīng)性皮炎（異位皮炎）

Allergicandcontactdermatitis過敏性和接觸性皮炎

Lichensimplexchronicus神經(jīng)性皮炎

Acne痤瘡，粉刺

Folliculitis毛囊炎

Herpesinfection皰疹病毒感染

Drugreaction藥物皮炎

Arthropodbitereaction蚊蟲叮咬

Dermatophysis皮癬

Psoriasis銀屑癬，牛皮癬

Lupuserythematosus紅斑狼瘡

Uticaria蕁麻疹

Alopeciaareata斑禿Commoninflammatoryskinconditions常見炎癥皮膚病變Eczema,atopicdermatitis濕Eczema,atopicdermatitis濕疹，特應(yīng)性皮炎

Allergicdermatitis過敏性性皮炎

Urticariareaction蕁麻疹

Zoster帶狀皰疹

Lichensimplexchronicus神經(jīng)性皮炎

Psoriasis銀屑癬

Autoimmunedermatitis自身免疫皮炎

Alopecia脫發(fā)

Wart,verruca疣

SkinItching,pain皮膚瘙癢、疼痛

CommonInflammatorySkinDiseasesMayBeManagedbyTCMTherapies常見炎癥皮膚病的分類和適合中醫(yī)治療的病癥Eczema,atopicdermatitis濕疹，ApplicationofTCMDiagnosticPrinciplesintheExaminationandScreeningofSkinDiseases“望聞問切”在皮膚病診斷和鑒別診斷中的應(yīng)用望：Inspection聞：Listening&smelling問：Inquiry切：PalpationApplicationofTCMDiagnosticTreeIntegrativeApproachesintheManagementofEczema中西醫(yī)結(jié)合治療濕疹的三中方法中藥Herbs針灸Acupuncture3.生活和水土的改變Life&LandChangesTreeIntegrativeApproachesiAcupuncturePointsforEczemaManagement治療濕疹的常用針灸穴位神庭ShenTing曲池QuChi通里TongLi合谷HeGu陽陵泉YangLingQuan隱白YinBai足三里ZuSanLi太沖TaiChongAcupuncturePointsforEczemaAcupunctureShuPointsforEczemaManagement治療濕疹的常用針灸腧穴風(fēng)門FengMen肺腧FeiShu心腧XinShu脾腧PiShu胃腧WeiShu三焦腧SanJiaoShu腎腧ShenShu定喘DingChuanAcupunctureShuPointsforEczLocalAcupunctureAreaforEczemaManagement治療濕疹的局部針灸治區(qū)域LocalAcupunctureAreaforEcz重內(nèi)因病表治里，祥外治殊途同歸內(nèi)治：四型1.濕熱：龍膽瀉肝湯龍膽草、

黃芩、

梔子、

澤瀉、【木通】、車前子、當(dāng)歸、

生地黃、

柴胡、甘草膿皰：金銀花、連翹；便干：大青葉血熱：皮癬湯加減生地、丹皮、赤芍、黃芩、苦參、地膚子、白鮮皮、丹參、生甘草DrZhuRenkang’sExperienceinManagingEczema朱仁康治療濕疹經(jīng)驗(yàn)重內(nèi)因病表治里，祥外治殊途同歸DrZhuRenkang’內(nèi)治：脾濕：胃苓湯加減蒼術(shù)、陳皮、茯苓、澤瀉、六一散、白鮮皮胃呆：藿香、佩蘭；腹脹：川樸、大腹皮陰傷：滋陰除濕法生地、元參、當(dāng)歸、丹參、茯苓、澤瀉、白鮮皮、蛇床子禁忌：重用燥濕和利濕之品DrZhuRenkang’sExperienceinManagingEczema朱仁康治療濕疹經(jīng)驗(yàn)內(nèi)治：DrZhuRenkang’sExperience外治：1. 濕敷：急性期滲出黃柏或馬齒莧或生地榆30克煎汁，用紗布浸透，外敷藥膏：各期均可以濕疹膏等粉劑：急性期藥粉加植物油：青黛、螵蛸、鍛石膏、冰片DrZhuRenkang’sExperienceinManagingEczema朱仁康治療濕疹經(jīng)驗(yàn)外治：DrZhuRenkang’sExperience辨濕疹，要在濕熱互結(jié)，治頑癥用“全蟲”內(nèi)治：二型1.熱盛型：龍膽草6、

黃芩9、

黃連6、

澤瀉9、梔子6、車前草15生地黃15、

連翹9、槐花9、甘草3【木通3】

便干：川軍、枳殼；下焦?jié)駸幔狐S柏；滲液多：茵陳

頭部：藁本；腰背：杜仲；上肢：姜黃；

下肢：牛膝或木瓜；瘙癢：白鮮皮、地膚子、苦參2.濕盛型：厚樸9、陳皮6、澤瀉9、黃柏9、茯苓9、豬苓9、枳殼9、薏米9白術(shù)9、車前子9

濕重：蒼術(shù)

頑癥方：全蟲（全蝎）6、皂角6、皂刺12、黃柏9、枳殼9、

苦參6、白鮮皮15、威靈仙12、生槐花15DrZhaoBingnan’sExperienceinManagingEczema趙炳南治療濕疹經(jīng)驗(yàn)辨濕疹，要在濕熱互結(jié)，治頑癥用“全蟲”內(nèi)治：濕熱血燥，脾虛濕停

內(nèi)治：分三型濕熱互結(jié)，熱重于濕：清熱除濕：生石膏、山梔、黃芩、龍膽草涼血：生地、丹皮清熱利水：車前草、車前子、冬瓜皮、馬齒莧、六一散脾虛脾虛濕盛，濕蘊(yùn)肌膚

健脾除濕：白術(shù)、蒼術(shù)、薏苡仁、枳殼、厚樸

利水除濕：車前子、澤瀉、茯苓皮、冬瓜皮、豬苓

除濕止癢：馬齒莧、苦參

養(yǎng)血潤膚：當(dāng)歸、丹參、赤芍陰虛血燥，氣血瘀滯

育因滋燥：熟地、天麥冬、女貞子、旱蓮草、元參

養(yǎng)血潤膚：當(dāng)歸、赤白芍、桃仁、紅花、丹參、首烏

除濕止癢：白鮮皮、澤瀉、茯苓、苦參

DrZhangZhili’sExperienceinManagingEczema張志禮治療濕疹經(jīng)驗(yàn)濕熱血燥，脾虛濕停 內(nèi)治：分三型DrZhangZhilDr.GanZhuwang’sExperience

干祖望祛濕清熱經(jīng)驗(yàn)方Dr.GanZhuwang’sExperience

干

蒼術(shù)：

燥濕 CangZhu:eliminatingdampness黃柏：

清熱 HuangBai:clearingheat忍冬藤：

祛風(fēng) RenDongTeng:dispellingwind薄荷：

宣表 BeHe:diffusingexterior牡丹皮：

活血 MuDanPi:promotingbloodcirculation*AclinicaltrialofthisformulawasdoneinHongKongBasicFormulaforEczemainChildren兒童濕疹基本方 BasicFormulaforEczemainCCaseAnalysisonTCMManagement中醫(yī)藥和針灸治療病例介紹CaseAnalysisonTCMManagemenWesternDiagnosis&TCMManagementforCommonSkinDiseases常見皮膚病的西醫(yī)診斷和中醫(yī)治療YongMingLi,MD,PhD李永明博士醫(yī)師常見皮膚病的西醫(yī)診斷和中醫(yī)治療課件 針灸醫(yī)生最常見的疾病是什么？答案不是經(jīng)常治療的疼痛或抑郁 癥，而是皮膚病。 針灸醫(yī)生在“尋經(jīng)取穴”時(shí)可以“順便”檢查患者的皮膚病變，這 是其它科醫(yī)生沒有的方便條件。

但是，很多針灸醫(yī)生沒有受過皮膚病診斷的訓(xùn)練，只好視而不見。

美國是個(gè)移民國家，不同種族的病人皮膚病種類繁多，尤其是白種

人皮膚癌發(fā)病率極高，不及時(shí)診斷，可能危及生命。

針灸師如果能夠掌握簡單皮膚病診斷技能，對患者和提高行醫(yī)水準(zhǔn)

都會(huì)十分有益。

中醫(yī)中藥和針灸在治療一些炎癥皮膚病和某些疑難皮膚病有很多優(yōu)

勢，每位中醫(yī)師和針灸師都應(yīng)該在臨床上探索使用。

Whyanacupuncturistneedtoknowskindiseases？針灸醫(yī)生為什么需要皮膚疾病？ 針灸醫(yī)生最常見的疾病是什么？答案不是經(jīng)常治療的疼痛或抑Whyanacupuncturistneedtoknowskindiseases？針灸醫(yī)生為什么需要皮膚疾病？ Whatisthemostcommonconditionencounteredbyan acupuncturist? Theanswerisnotpainordepressionbutthe skinproblem. Whilelocatingacupoints,anacupuncturisthastheadvantageto reviewmostskinlesions,butotherspecialistsdonothave. Unfortunately,manypractitionerswhohaveinsufficient dermatological trainingchoosetoignoreskinproblems. VariouscomplicatedskindiseasesmightbeseenintheUSA andlightskinindividualsarespecialpronetoskincancer. Anacupuncturistwithbasicdermatologicalexpertisecanbea greatbenefittopatientsaswellastohis/herownpractice. AcupunctureandTCMherbsareknowntobegoodalternative options forcertainskindiseases.Whyanacupuncturistneedtok1.美國最常見皮膚病的分類

2.皮膚惡性腫瘤的臨床特征和鑒別診斷

3.常見炎癥皮膚病的分類和適合中醫(yī)治療的病癥

4.“望聞問切”在皮膚病診斷和鑒別診斷中的應(yīng)用

5.中醫(yī)藥和針灸治療病例介紹1.TheclassificationofcommonlyseenskindiseasesintheUSA2.ClinicalfeaturesanddiagnosisofmalignantskintumorsCommonlyseeninflammatoryskindiseasesandconditionsmaybemanagedbyTCMtherapiesApplicationofTCMdiagnosticprinciplesintheexaminationandscreeningofskindiseases5.CaseanalysisonTCMmanagementWesternDiagnosis&TCMManagementforCommonSkinDiseases常見皮膚病的西醫(yī)診斷和中醫(yī)治療1.美國最常見皮膚病的分類

2.皮膚惡性腫瘤Classificationofcommonskinconditions常見皮膚病分類Skindiseases皮膚病變Non-inflammatory非炎癥Neoplasm腫瘤Benigntumor良性腫瘤Malignanttumor惡性腫瘤Non-neoplasm非腫瘤Physiologicalchange生理改變Pathologicalchanges病理改變Inflammatory炎癥Infection感染Virusinfection病毒感染Microorganisminfection菌類感染Non-infection非感染Autoimmune自身免疫Nonspecificinflammation非特異炎癥ClassificationofcommonskinSeborrheickeratosis(SK)脂溢性角化病

Melanocyticnevus(mole)黑色素痣

Solarkeratosis(actinickeratosis)日光性角化病

Fibroepithelialpolyp(skintag)纖維上皮息肉

Epidermalcyst(sebaceouscyst）表皮囊腫

Verrucavulgaris,condyloma(wart)尋常疣，濕疣

Dermalscar(keloid)皮膚疤痕，瘢痕疙瘩

Dermatofibroma皮膚纖維瘤

Neurofibroma纖維神經(jīng)瘤

Hemangioma血管瘤

Basalcellcarcinoma(BCC)基底細(xì)胞癌

Squamouscellcarcinoma(SCC)鱗狀細(xì)胞癌

Malignantmelanoma(melanoma)惡性黑素瘤Commonnon-inflammatoryskinconditions常見非炎癥皮膚病變Seborrheickeratosis(SK)脂溢ClinicalFeaturesandDiagnosisofMalignantSkinTumors皮膚惡性腫瘤的臨床特征和鑒別診斷Basalcellcarcinoma(BCC)基底細(xì)胞癌

Squamouscellcarcinoma(SCC)鱗狀細(xì)胞癌

Malignantmelanoma(melanoma)惡性黑素瘤Lymphoma,leukemia淋巴瘤，白血病Softtissuemalignanttumor軟組織惡性腫瘤Metastaticcancer轉(zhuǎn)移癌ClinicalFeaturesandDiagnosiClinicalFeaturesofMalignantmelanoma惡性黑素瘤的臨床特征ClinicalFeaturesofMalignantEczema,atopicdermatitis濕疹，特應(yīng)性皮炎（異位皮炎）

Allergicandcontactdermatitis過敏性和接觸性皮炎

Lichensimplexchronicus神經(jīng)性皮炎

Acne痤瘡，粉刺

Folliculitis毛囊炎

Herpesinfection皰疹病毒感染

Drugreaction藥物皮炎

Arthropodbitereaction蚊蟲叮咬

Dermatophysis皮癬

Psoriasis銀屑癬，牛皮癬

Lupuserythematosus紅斑狼瘡

Uticaria蕁麻疹

Alopeciaareata斑禿Commoninflammatoryskinconditions常見炎癥皮膚病變Eczema,atopicdermatitis濕Eczema,atopicdermatitis濕疹，特應(yīng)性皮炎

Allergicdermatitis過敏性性皮炎

Urticariareaction蕁麻疹

Zoster帶狀皰疹

Lichensimplexchronicus神經(jīng)性皮炎

Psoriasis銀屑癬

Autoimmunedermatitis自身免疫皮炎

Alopecia脫發(fā)

Wart,verruca疣

SkinItching,pain皮膚瘙癢、疼痛

CommonInflammatorySkinDiseasesMayBeManagedbyTCMTherapies常見炎癥皮膚病的分類和適合中醫(yī)治療的病癥Eczema,atopicdermatitis濕疹，ApplicationofTCMDiagnosticPrinciplesintheExaminationandScreeningofSkinDiseases“望聞問切”在皮膚病診斷和鑒別診斷中的應(yīng)用望：Inspection聞：Listening&smelling問：Inquiry切：PalpationApplicationofTCMDiagnosticTreeIntegrativeApproachesintheManagementofEczema中西醫(yī)結(jié)合治療濕疹的三中方法中藥Herbs針灸Acupuncture3.生活和水土的改變Life&LandChangesTreeIntegrativeApproachesiAcupuncturePointsforEczemaManagement治療濕疹的常用針灸穴位神庭ShenTing曲池QuChi通里TongLi合谷HeGu陽陵泉YangLingQuan隱白YinBai足三里ZuSanLi太沖TaiChongAcupuncturePointsforEczemaAcupunctureShuPointsforEczemaManagement治療濕疹的常用針灸腧穴風(fēng)門FengMen肺腧FeiShu心腧XinShu脾腧PiShu胃腧WeiShu三焦腧SanJiaoShu腎腧ShenShu定喘DingChuanAcupunctureShuPointsforEczLocalAcupunctureAreaforEczemaManagement治療濕疹的局部針灸治區(qū)域LocalAcupunctureAreaforEcz重內(nèi)因病表治里，祥外治殊途同歸內(nèi)治：四型1.濕熱：龍膽瀉肝湯龍膽草、

黃芩、

梔子、

澤瀉、【木通】、車前子、當(dāng)歸、

生地黃、

柴胡、甘草膿皰：金銀花、連翹；便干：大青葉血熱：皮癬湯加減生地、丹皮、赤芍、黃芩、苦參、地膚子、白鮮皮、丹參、生甘草DrZhuRenkang’sExperienceinManagingEczema朱仁康治療濕疹經(jīng)驗(yàn)重內(nèi)因病表治里，祥外治殊途同歸DrZhuRenkang’內(nèi)治：脾濕：胃苓湯加減蒼術(shù)、陳皮、茯苓、澤瀉、六一散、白鮮皮胃呆：藿香、佩蘭；腹脹：川樸、大腹皮陰傷：滋陰除濕法生地、元參、當(dāng)歸、丹參、茯苓、澤瀉、白鮮皮、蛇床子禁忌：重用燥濕和利濕之品DrZhuRenkang’sExperienceinManagingEczema朱仁康治療濕疹經(jīng)驗(yàn)內(nèi)治：DrZhuRenkang’sExperience外治：1. 濕敷：急性期滲出黃柏或馬齒莧或生地榆30克煎汁，用紗布浸透，外敷藥膏：各期均可以濕疹膏等粉劑：急性期藥粉加植物油：青黛、螵蛸、鍛石膏、冰片DrZh