中医杂志

总结白彦萍教授治疗玫瑰痤疮的临证经验。认为皮络郁热是玫瑰痤疮的核心病机，瘀热互结、皮络阻滞是其关键病理环节，养血活血化瘀、清热解郁通络为核心治法。临证以温清饮为基础方，并结合玫瑰痤疮不同临床表型和分期进行灵活加减。红斑毛细血管扩张型侧重活血通络、清热凉血；丘疹脓疱型强化清热解毒、化瘀散结；肥大增生型兼顾软坚散结、养血润肤；眼型注重清肝明目、通窍清热。急性期侧重清热解毒凉血，慢性迁延期瘀热并调、养血通络，巩固期健脾益气、扶正祛邪。同时重视香药、血分药、引经药的精准配伍，兼顾整体与局部，内治与外治相结合，可为中医治疗玫瑰痤疮提供临床思路。

This paper summarizes professor BAI Yanping's clinical experience in treating rosacea. It is believed that stagnant heat in cutaneous collaterals serves as the core pathogenesis of rosacea, and the interbinding of static blood and heat as well as blockage of cutaneous collaterals constitute the key pathological links. The core therapeutic principles consist of nourishing blood, activating blood circulation to resolve stasis, clearing heat, relieving stagnation and unblocking collaterals. In clinic, Wenqing Decoction （温清饮） is adopted as the basic formula, with flexible modifications according to distinct clinical syndromes and stages of rosacea. Based on clinical syndromes, for erythematotelangiectatic rosacea, the treatment should focus on activating blood to unblock collaterals, clearing heat and cooling blood; for papulopustular rosacea, the treatment should focus on clearing heat and resolving toxins, and resolving stasis and dissipating masses; for hypertrophic phymatous rosacea, the treatment should simultaneously softening hard masses, dissipating stagnation, nourishing blood and moisturizing the skin; for ocular rosacea, the treatment should prioritize clearing liver heat to improve eyesight, unblocking orifices and eliminating heat. Based on the stages, in acute phase, heat-clearing, detoxifying and blood-cooling therapies are emphasized; for protracted chronic phase, concurrent regulation of static blood and heat plus blood-nourishing and collateral-unblocking methods are applied; the consolidation stage targets invigorating the spleen and replenishing qi to strengthen vital resistance and eliminate pathogenic factors. Meanwhile, precise compatibility of aromatic medicinals, blood-level medicinals and channelguiding medicinals is highly valued. The therapy should balance systemic regulation and local lesion care, and combine internal and external treatment, which may provides clinical references for TCM intervention of rosacea.