2 English reference sore [Chinese medicine terminology examination and approval Committee. Terminology of Traditional Chinese Medicine (2004)]
Neurodermatitis [Terminology Committee of Traditional Chinese Medicine]. Terminology of Traditional Chinese Medicine (2004)]
Conclusion napesores neurodermatitis [1] is the name of the disease [2]. Also known as psoriasis [1].
Psoriasis (psoriasis) is the name of this disease. See Effective Treatment Prescriptions of World Famous Doctors, Volume XIX. In the literature of traditional Chinese medicine, it is called collar sore because it is easy to occur in the neck; Because of its stubbornness, it is also called stubborn tinea. Refers to a chronic itchy skin disease, which often occurs in the neck, elbow and other places, and is characterized by being stubborn and firm like cowhide [3]. Because the affected skin is thick and firm, such as cow collar skin, it is named [4]. It is due to the accumulation of wind, dampness and heat in the skin, or blood deficiency and wind dryness for a long time, and skin malnutrition (the poison of rheumatic fever is accumulated in the skin); Or due to deficiency of qi and blood, blood deficiency and wind dryness, and skin dystrophy; It also has a certain relationship with emotional disorders [4])[5]. This disease is characterized by local lichenoid transformation of the skin, accompanied by severe itching. It happens to young people. Chronic disease course, sometimes light and sometimes heavy, aggravated in summer and relieved in winter.
On the Causes and Symptoms of Neck Ulcer: "Neck Ulcer, like tinea, is caused by itchy neck and rubbing the collar, hence the name."
"Authentic Surgical Stubborn Tinea" said: "Psoriasis is like the skin on the neck of a cow, stubborn and firm. Grab it like rotten wood. "
Neck sore is equivalent to neurodermatitis [3] and chronic eczema [5] in western medicine.
4 Etiology and Pathogenesis of Neck Ulcer Neck Ulcer is caused by wind, dampness and heat, or blood deficiency and wind dryness for a long time, resulting in skin dystrophy (wind, dampness, heat and toxic skin depression; Or due to deficiency of qi and blood, blood deficiency and wind dryness, and skin dystrophy; It also has a certain relationship with emotional disorders [4])[5].
Emotional internal injury and wind evil invasion are the inducing factors of psoriasis, while disharmony in nourishing blood, disorder of meridians and collaterals, qi stagnation and blood stasis are its pathogenesis;
At first, it was mostly caused by the evil of rheumatic fever blocking the skin, or sweating on the neck and hard collar friction;
Long-term illness consumes yin and body fluid, qi and blood are insufficient, blood deficiency produces wind dryness, and skin malnutrition;
Deficiency of blood and hyperactivity of liver, emotional frustration, mental depression, or nervous fatigue, inflammation of heart fire, leading to dereliction of duty in the operation of qi and blood and stagnation of skin, are all easy to become important inducing factors, leading to recurrent attacks.
5 Symptoms of Neck Pain Neck pain in the back of the neck is the most common, followed by elbow bend and knee bend, upper eyelid and inner thigh (mostly in the neck, but also in elbow fossa, popliteal fossa, upper eyelid, perineum and inner thigh [4])[5]. At the beginning of the disease, the skin itches, and flat papules appear locally, which merge into pieces. Over time, the skin lesions become thick, dry and desquamate. Paroxysmal itching, especially at night and when you are depressed and irritable [5]. The course of disease is long and easy to recur [5].
6 Diagnosis of collar sores Neck sores are mainly found in the neck, elbow, sacrum and leg extensions. It is often symmetrically distributed and can also be arranged in a straight line along the cutaneous nerve.
The skin lesions are polygonal flat papules at first, with a tendency to aggregate, normal or slightly flushed skin color, shiny surface or covered with thin bran scales. Later, due to constant scratching or rubbing, the papules gradually expanded and merged with each other, and then the local skin thickened, the texture deepened and crossed each other, and the surface was dry and rough, with a little gray scales, but changed like moss. Skin lesions can be round or irregular patches, and their boundaries are the result of scratching. Scratching, bleeding spots or blood scabs may accompany the affected parts and their surroundings, and new small and flat papules may appear nearby.
I feel paroxysmal itching, especially when clothes rub and sweat stains, especially at night, and I don't know the pain when I scratch them. When mood swings, itching will also increase. Because itching will affect work and rest, patients are often accompanied by insomnia, dizziness, irritability and other symptoms.
Psoriasis has a slow course, perennial unhealed and recurrent attacks.
Clinically, it can be divided into systemic type and localized type according to the location of the disease and the number of lesions. Localized, the lesion is only found in the neck and other parts, and it is a few lichenoid hypertrophic plaques with clear boundaries; Hair is extensive, widely distributed, and prone to head, limbs, shoulders, waist and other places, even the whole body hair is extensive, and the characteristics of skin lesions are the same as those of localized types.
7 Diseases that need to be differentiated from collar sores 7. 1 Chronic wet sores Chronic wet sores often have the onset process of acute wet sores such as skin flushing, papules, blisters, erosion and exudation. Skin lesions are mainly thick and rough, accompanied by rashes, blisters, erosion and exudation, with unclear boundaries, and skin lesions are mostly on the flexion side of limbs.
7.2 Skin amyloidosis mainly occurs on the back and extension side of the calf. The skin is a dome-shaped papule the size of sorghum rice, with purple-brown color, hard texture, dense granules and rough keratinization.
7.3 The white furuncle skin lesion is reddish at the base, covered with silvery white furry scales, with film phenomenon and punctate bleeding after peeling.
8 treatment of collar sores The treatment of collar sores should promote blood circulation and dispel wind, clear away heat and promote diuresis [4]. Danggui Yinzi can be taken orally [4]. Crazy ointment and black bean distillate can be used externally, and fumigation therapy and plum blossom needle therapy can also be selected [4].
8. 1 Syndrome Differentiation and Treatment 8. 1. 1 Cow skin lichen with liver depression and fire refers to liver depression and fire, external burning of the skin, redness and swelling of the skin, restlessness, insomnia and dreaminess, dizziness, palpitation, bitter taste, dry throat and red tip of the tongue.
8. 1. 1. 1 Symptoms: redness, restlessness, insomnia, dreaminess, dizziness, palpitation, bitter mouth and dry throat; The edge of the tongue is sharp and red, and the pulse string is numerous.
8. 1. 1.2 dialectical analysis of emotional internal injury, liver depression and qi stagnation; Liver fire stagnation, liver and gallbladder fire flourishing, fumigation of the skin, so the skin lesions are red; Hot interference leads to palpitation, irritability, insomnia and dreaminess; Bile overflows along meridians, causing bitter taste; Body fluid is burned by fire, and the throat is dry; Red tongue and the number of pulse strings are the images of liver meridian transforming into fire.
8. 1. 1.3 treatment: clearing liver and purging fire.
8. 1. 1.4 Prescription of Longdan Xiegan Decoction.
8. 1.2 Cowhide lichen with abundant rheumatism refers to psoriasis syndrome in which the skin is affected by rheumatism, and the skin lesions are light brown flaky lichen-like patches with rough and thick itching, especially at night with thin or greasy tongue coating and slow pulse as common symptoms [3].
8. 1.2. 1 Symptoms: The skin lesions are light brown, flaky, rough and thick, and should be done when itching is severe, especially at night; The coating is thin, white or greasy, and the pulse is slow.
8. 1.2.2 dialectical analysis shows that the pathogenic factors of rheumatism accumulate in the skin, the meridians are disordered, the local qi and blood stagnate, and the skin is malnourished, so the skin lesions are light brown and flaky, rough and thick; The wind itches; Yin points are disturbed, especially at night; Thin white or greasy fur and slow pulse are signs of rheumatism.
8. 1.2.3 Treatment of expelling wind and promoting diuresis.
8. 1.2.4 Xiaofeng powder.
8. 1.3 Cowhide lichen with blood dryness and wind dryness refers to psoriasis syndrome with blood deficiency and wind dryness. The lesions are gray, thick and rough as cowhide, grasping like dead wood, palpitation and insomnia's forgetfulness, irregular menstruation, pale tongue and thready pulse in women are common symptoms [3].
8. 1.3. 1 Symptoms: the lesions are gray, scratched like dead wood, thick and rough like cowhide; Accompanied by palpitation, insomnia and forgetfulness, irregular menstruation in women; The tongue is pale and the pulse is heavy and thin.
8. 1.3.2 Dialectical analysis shows that blood deficiency leads to weathering and dryness, and the skin loses nutrition, so the skin lesions are gray, grasping like dead wood, thick and rough as cowhide; Blood deficiency, mental dystrophy, so palpitations, insomnia, forgetfulness; Women use blood, blood deficiency and insufficient blood source, so menstruation is irregular; Pale tongue and thready pulse are manifestations of blood deficiency.
8. 1.3.3 treatment: nourishing blood, expelling wind and moistening dryness.
8. 1.3.4 Prescription is used to treat Siwu Xiaofeng Drink or Danggui Drink.
8.2 The external treatment of psoriasis is based on the principle of relieving itching:
For patients with thin skin lesions, external use of No.2 ringworm solution, Mylabris vinegar, Stemona tincture, Furong tincture, etc. , several times a day.
Thick skin lesions can be coated with moisturizing cream, black ointment, Veratrum paste, etc. Several times a day.
8.3 Acupuncture treatment 8.3. 1 body acupuncture 8.3. 1. 1 prescription 1 Quchi, Fengchi, Patio, Xue Hai, Sanyinjiao, Waiguan and Ashi are the main points [5]. When needling Ashi point, it is necessary to horizontally prick several needles from the periphery of the lesion to the base of the lesion, and moxa stick moxibustion can be added for about 20 minutes after needling [5]. Those with skin lesions in the nape will suffer from valley and column deficiency; If the elbow is bent and the skin is damaged, it is necessary to add a door and a labor palace; For patients with popliteal fossa lesions, floating door and vulva are added; For patients with upper eyelid lesions, it will increase the head dimension and Baihui; Sanyinjiao is added to those with skin lesions on the inner thigh; Shu Ge and Dadu are added to those with blood dryness and wind; For rheumatic fever, Yinling Spring and Fengchi points are added; If it is difficult to heal for a long time, you can bleed a few drops in the posterior ear vein [5].
8.3. 1.2. Take Quchi and Xue Hai for example; Spare points are Hegu point and Sanyinjiao point. Medium and strong * * *, every day 1 time, 15 ~ 30 minutes.
8.3.2 Skin needle 8.3.2. 1 prescription 1 Tap the focus from the periphery to the center and add cupping, once a day 1 time [5].
If the lichen of 8.3.2.2 Formula II becomes obvious, you can tap the skin lesions with a plum blossom needle, with a small amount of oozing blood as the degree, every day 1 time.
8.3.3 Ear acupuncture is located in lung, Shenmen, lower shoulder, liver and brain. It is moderate * * *, and the needle is kept for 65,438+0 hours [5]. Pay attention to avoid using sexual objects, scratching and scalding with hot water during treatment [5].
Daily health care of patients with sores 1. Avoid smoking, wine, peppers and other * * * foods, and it is forbidden to grasp them by hand or scald them with hot water.
2. Wear cotton products for underwear, not hard clothes to avoid skin.
3. Keep a good mood and avoid mental * * *.
10