Vitiligo is a common acquired pigment loss skin mucosal disease, which is manifested by the destruction of melanocytes in the skin and mucous membranes, and the melanocytes in the lesion area are significantly reduced or disappeared. About 50% of the patients have the disease before the age of 20, and the average age of onset of childhood patients in China is 7.52 years. Because of the long duration of the disease and its cosmetic effects, patients often suffer from different degrees of psychological effects, especially children and adolescents with immature psychological development. How to choose a safe, effective and individualized treatment plan for pediatric patients has become an important issue for clinicians and parents.
This disease belongs to the category of “white barge wind” in Chinese medicine, and its main etiology is due to external invasion of wind, loss of harmony between qi and blood, and deficiency of liver and kidney. The main cause and mechanism of the disease is the external invasion of wind, loss of qi and blood, and deficiency of liver and kidney. In the “Secrets of Infant Care”, the five viscera are not sufficient. It is pointed out in the General Theory of the Treatment of the Five Organs that “among the five organs, the liver has a surplus, the spleen is often deficient, and the kidneys are always deficient.” The author, through years of clinical experience, believes that children vitiligo is mainly caused by the diet partiality, or anorexia to spleen and stomach weakness; or due to congenital deficiency, kidney deficiency; or with the lung Qi is not solid, Ying and Wei disorder. The overall treatment method is based on the lung, spleen and kidney, and is experienced as follows.
Identification of evidence and treatment
1.Spleen and stomach disharmony
Main evidence: Pale white patches on the skin, especially around the mouth, corners of the lips and feet. With loss of appetite, abdominal distension after eating, irritability and crying, with breath, abdominal distension, dry or thin stools. The face is yellowish, thin, sleepless at night, head sweating, sleep on the stomach, eyes leak during sleep. The tongue is red and the tongue coating is white, thick or greasy.
Treatment: Strengthening the spleen and stomach, appetizing the stomach and eliminating food
Remedy: Xiang Sha Liu Jun Zi Tang with reduction
Traditional Chinese medicine: Ginseng and Spleen Tablets, Gastrointestinal Dissipative Tablets, Baohe Pill, Ginseng and Atractylodes, Six Junzi Pill
Analysis of disease mechanism: The spleen and stomach jointly preside over the digestion and absorption of food and drink, but each has its own characteristics. The stomach is the main receiver, the spleen is the main transporter; the stomach is the main descender, so that the food and its dregs can go down, the spleen is the main ascender, so that the essence of the food can nourish the whole body; the stomach likes to moisten and hate dryness, the spleen likes dryness and hate dampness. This kind of nano and chemistry, ascending and descending, moist and dry, complement each other in opposition and unity. Spleen and stomach disharmony is a disorder of this unity of opposites. Clinical reasons that can cause dysfunction of the spleen and stomach, such as uncontrolled diet (clean), partial food, food addiction, excessive consumption of spicy, spicy, etc. can lead to spleen and stomach disharmony, and over time, the biochemical lack of source of qi and blood, skin loss of nourishment, and white spots.
2.Lung health is not solid evidence
Main evidence: pale white skin patches, especially on the face, chest and hands. With sweating and vicious wind, a little movement sweating especially, or performance of half body, a local sweating, easy to catch a cold, runny nose, cough, body fatigue, body aches and pains, face s white, less Hua, moss thin white, weak pulse.
Treatment: Benefit qi and consolidate surface, harmonize Ying and Wei
Remedy: Gui Zhi plus Huang Qi Tang or Yu Ping Feng San with addition and reduction. (lily,)
Chinese patent medicine: Yu Ping Feng granules, Qizao granules
Analysis of the disease mechanism: the lung is the main propagator, regulating the opening and closing of the couples, lung Qi deficiency, table deficiency and loss of consolidation, Ying and Wei is not harmonized, sweating out, so see sweating and vicious wind, easy to catch a cold; Qi deficiency, the body is not nourished, the face s white, less Hua; Qi deficiency, the body is tired and weak; the lung is the main skin, lung Qi deficiency, can not nourish the skin, the skin porcelain white or pale.
3, liver and kidney deficiency evidence
The main evidence: skin, hair or hair white, mainly in the breast, vulva, perianal, small abdomen, limb skin porcelain white or white, accompanied by memory loss memory loss, inattention, fatigue and drowsiness, irritability, irritability, night sweats, hyperactivity, insomnia and dreaminess or sleepwalking. Soreness and weakness of the waist and knees, loose teeth, clear and long urine or nocturia and bedwetting. Red tongue with little coating and fine pulse.
Treatment: Nourishing the liver and kidney
Remedies: Zuo Gui Wan or Kidney Qi Wan with addition or reduction.
Traditional Chinese medicine: Kidney Qi Pill, Zuoguai Pill, Tianma Shouwu Tablet
Pathological analysis: kidney is the origin of the innate, its glory in the hair, kidney essence deficiency, hair loss of nourishment, the skin, hair or hair white, liver and kidney homologation, pathology between the liver and kidney is often affected by each other, the liver meridian where the skin hair grams involved. Liver and kidney yin deficiency, loss of medulla oblongata, then memory loss, memory loss, inattention; liver yin deficiency, yin deficiency internal heat, then irritability, irritability, internal compulsion Ying yin, then night sweats, liver and kidney yin deficiency can not Confucian tendons measured waist and knees soreness. If there is internal disturbance of deficiency fire, the mind is restless, then insomnia and dreaminess or sleepwalking.
4.Qi stagnation and blood stasis evidence
The main evidence: the white spots occur in a certain part of the body, the location is relatively fixed, the lesions are mostly asymmetric white spots, clear borders, mostly after trauma or other skin damage, the white spots are dark, there may be a slightly painful feeling within the spot hair whitening, the progress of the disease is slow, can be accompanied by facial dullness, skin nail wrong tongue purple dark or petechiae, sublingual veins tortuous, thin moss, thin and astringent pulse accompanied by chest and abdominal distension, gas depression and restlessness. Slow development, long course, easily followed by trauma, with bruising, redness, swelling and tingling of the skin.
Treatment: Invigorate blood circulation, remove blood stasis and dredge meridians.
Remedy: Peach-Hong Siwu Tang with Addition
Traditional Chinese medicine: Peach Red Blood Clearing Pill, Wulong San, Vitiligo Pill
Analysis: Due to stagnation of qi and blood, obstruction of meridians and channels, blockage of hairs and orifices, and inability to nourish the body and skin, the white spots are caused by blood stasis in the skin, as stated in the “Medical Lin Correction”.