This disease is named after the inflammatory papules that occur on the face and chest and back, and the white powder that appears when squeezed, also known as pulmonary wind acne. In modern medicine, it is called acne. It occurs in young men and women, and most of them heal naturally after puberty.
Etiology]
This disease is caused by the fumigation of wind-heat in the skin by the lung meridian, or by excessive consumption of oily and spicy products, and by the accumulation of dampness and heat in the spleen and stomach, which can offend the skin externally.
Modern medicine believes that this disease is caused by excessive sebum secretion, and then secondary bacterial infection.
Identification】
The rash is usually found on the face, upper chest, shoulders, back and other sebaceous areas. The disease can often be clinically classified into three types.
(i) Lung meridian wind-heat type with flushed facial complexion, predominantly papular damage, may have pustules, etc., red tongue tip, thin yellow coating, and counted pulse.
(ii) Spleen and stomach damp-heat type The skin on the face is oily and uncomfortable, with papules or pustules, nodules, etc., often accompanied by constipation, yellow tongue coating, and moist pulse.
(iii) Irregularity of the spleen and stomach. The disease is often cyclical, closely related to menstrual changes, and may be accompanied by irregular menstruation or dysmenorrhea, with a dull red tongue, thin yellow fur, and a thin pulse.
Treatment
The disease has a tendency to heal itself, and mild cases can be treated without treatment. The disease has a tendency to heal on its own, and in mild cases, no treatment is necessary. Wash your face with hot soap to reduce greasiness; eat less fat and sugar, avoid spicy food and alcohol, eat more fruits and vegetables, keep good digestion and prevent constipation.
I. Internal treatment
1, the lung meridian wind-heat type should be dredged to clear the lung, with loquat clear lung drink plus or minus, optional addition of white flower snake tongue grass, fishy grass, etc.
2, the type of damp-heat in the spleen and stomach should be cleared and damp-heat should be cleared, with addition and subtraction of Yin Chen Artemisia Tang, with optional addition of bitter ginseng, fire charcoal mother and fenugreek.
3. For the type of dysregulation of the flushes, it is advisable to regulate the flushes and release the liver to relieve depression.
Second, external treatment is often used in the form of Upside Down San or San Huang lotion.
Source: National higher medical institutions trial textbook “Surgery” (for Chinese medicine) 1980 edition with.
1, loquat Qing lung drink (“medical jinjian”) ginseng, loquat leaf, licorice, Huanglian, mulberry white peel, cypress 2, Yin Chen Artemisia Tang (“treatise on typhoid”) Yin Chen Artemisia, mountain gardenia, rhubarb 3, free and easy san (“bureau formula”) Chai Hu, white peony, angelica, white atractylodes, poria, roasted grass, ginger, peppermint 4, upside down san (“medical jinjian”) rhubarb, sulfur, etc. 5, three yellow lotion (experience formula) rhubarb, cypress, baicalin Although the above identification and treatment is more authoritative, it is relatively simple and still has a sense of incompleteness in clinical application. The following is a richer and more applicable version of the typology.
Acne is a common clinical condition in dermatology. It can be divided into common and cystic acne, nodular acne, and coalescent acne according to the severity of the rash. Depending on the age, acne can be divided into pubertal acne and post-pubertal acne. Acne has a single clinical manifestation, often with symptoms such as acne, inflammatory papules, cysts, and nodules, but the symptoms of acne are complex. According to clinical experience, the application of TCM evidence-based treatment, while referring to the patient’s age, symptoms, and site of onset, has been effective.
1.Heat in the lung and stomach
According to Chinese medicine, the face and nose are dominated by the two meridians of the lungs and stomach. If the lung meridian is hot and the lung meridian is hot, and if the lung meridian is exposed to wind (wind tends to attack the upper part of the body), then “lung wind acne” will occur.
This type of acne is most common in inflammatory acne, the patient is often in adolescence, the rash is usually on the face, there can be a small amount of rash on the chest and back, the lesions are mainly red papules, some have pus heads, itchy and painful, the tongue is red, the coating is thin white or thin yellow, the pulse is slippery or slightly thin, the stool is dry. The formula is based on the treatment method of “diarrhea instead of clearing”, which is to pass through the internal organs and remove wind-heat in the lung meridian. If there is heat in the heart of hands and feet, add 20g of Lady’s Mantle and 20g of Dry Lotus Grass to cool the blood and regulate the hormone level; if the stool is loose after the medicine, remove raw rhubarb and add 15g of fried Citrus aurantium to slow down the medicinal properties.
2.Dampness and evil accumulation
From a clinical point of view, facial greasiness is the most common manifestation of acne lesions, which originates from the vigorous vitality of the body during adolescence. According to Chinese medicine, sebum is related to “dampness”, and the source of dampness is twofold: first, the spleen and stomach are injured by the spicy and stimulating food, and the spleen loses its health, so dampness is generated inside. Second, the kidney Yang deficiency, no to warm the spleen Yang, resulting in water and dampness stagnation. If dampness accumulates over time, it becomes phlegm and forms nodules and cysts; if dampness becomes heat, heat becomes flesh and rotting, it becomes pus and forms pus head. Therefore, the clinical treatment should be based on the legislation of strengthening the spleen, promoting dampness, warming Yang, removing dampness, clearing heat and eliminating stagnation.
The typical symptoms of this type of patients are more oil on the face, often in adolescence, the rash is mainly on the face, the lesions are mainly red papules and acne, the face is usually greasy, the “T” area is heavy, itchy and painful, the tongue is pale or with teeth marks on the side, the moss is thin and white, the pulse is smooth, and the stool is regulated; if the rash is mainly around the mouth, the patient is often accompanied by stool The patient often has loose stools.
If the rash is mainly perioral, add 15g of gardenia and 15g of patchouli (diarrhea and yellow powder) to relieve the fire in the spleen. If the area is mainly around the mouth, add Gardenia 15g and Huanghuang 15g (cut from Diarrhea Huang San) to relieve the fire in the Spleen meridian; if the stool is loose, add Fangfeng 15g, Qiangwu 15g and Ganjiang 10g to promote Yang and remove dampness.
3.Dysregulation of the flushing and the dampness
This type is common in patients with onset after puberty. Before the onset of menstruation, menstrual blood is full and easily provoked by liver qi, which is inflammatory and refines fluid into phlegm, resulting in acne. The kidneys are the main sealers of the body. A disorder of the liver and kidneys can lead to menstrual disorders, endocrine disorders and acne. If the patient has generalized symptoms such as fever in the heart of the hands and feet, night sweats, etc., it is due to kidney yin deficiency and deficiency fire, so the treatment is to nourish yin and lower the fire. Because the liver and kidney are of the same origin, treatment should take into account each other, nourishing kidney yin without forgetting to clear liver fire and warming kidney yang while warming liver yang.
This type of lesion is concentrated on the face, with dark red papules and nodules, sometimes painful, with a pale tongue with thin white coating and a smooth or thin pulse, accompanied by irregular menstruation, often with blood clots. If the nodule is the main problem, add 30g of Zhaobei Mu, 30g of raw oyster, 15g of Xia Ku Cao, and 1 centipede to soften and disperse the nodule.
4.Heat toxin congestion
Toxins include wind, dampness, stasis, heat and fire. In the Nei Jing, it is stated that toxins are “all evidence of hyperactive Yang heat”.
Patients with this type of acne have a rapid onset, heavy clinical symptoms, greasy face, and lesions that are mainly nodules, cysts, abscesses, and blackheads, which belong to the category of cystic and coalescent acne in Western medicine. Some patients have a red tongue, thin yellow or greasy coating, and a smooth or small pulse. In these patients, the skin lesions are mainly purulent, so the treatment should start with sores and ulcers, with large doses of blood cooling and heat-clearing drugs, as well as cooling the blood, dispelling dampness, and softening and dispersing knots. The formula is based on Wu Wei Disinfectant Drink combined with Xian Fang Livestrong Drink: Jin Yin Hua 30g, Lian Qiao 15g, Gong Ying 30g, Zi Hua Di Ding 20g, Bai Zhi 20g, Zhe Bei Mu 30g, Tian Tian Fan 20g, Yin Chen 15g, Angelica Sinensis 15g, Roasted Frankincense 15g, Chen Pi 10g, Sheng Gan Cao 10g. If abscesses and nodules are more frequent, add 10g of Aju, 20g of Saponaria and 2 of Centipede to break blood and soften hardness; if stools are dry, add 15g of Raw Rhubarb to diarrhea and relax the bowels, dispel blood stasis and create new. It can be combined with external application of Jinhuang San to surround the swelling, and if abscess is formed, it needs to be combined with surgical incision to drain the pus.
5.Heat on the top and cold on the bottom
Patients of this type are mostly in adolescence, with inflammatory papules on the face, cold hands and feet, abdominal pain during menstruation, pale white coating on the tongue or petechiae on the edge of the tongue, slippery or thin or slow pulse, and loose or sometimes dry stools. The treatment is based on the deficiency of Yang in the body and the onset of the disease is due to the floating of the deficient Yang over the upper part of the body. The treatment is based on the principle of “inducing fire to return to the origin”, clearing the upper part of the body and warming the lower part of the body. If the stool is loose, add 10g of dry ginger and 20g of poria to warm the middle and stop diarrhea; if the stool is dry, add 15g of Angelica sinensis and 15g of Radix et Rhizoma Ginseng to clear the floating fire in the upper jiao and to relax the stool.
In addition, in the treatment should also consider the onset of the site of discretionary medicine. The onset of the disease in the frontal region belongs to the heart, which is often caused by hyperactive heart fire, and the heart fire moves down to the small intestine, therefore, yellow urine is common in clinical practice. The left cheek is for the liver, and the right cheek is for the lung, so those that occur in the cheeks are often due to liver fire offending the lung. The area around the mouth is the spleen, often due to damp heat in the spleen and stomach. The back is dominated by the Yang Ming meridian and is often due to Yang Qi deficiency and inability to defend the outside.