中医中药与针灸治疗脱发150 例 – Fu Mei-hua’s Treatment of 150 Cases of Hair Loss with Herbs and Acupuncture

中医中药与针灸治疗脱发150 例 – Treatment of 150 Cases of Hair Loss with Herbs and Acupuncture

富梅华
Translated by Xu Zhi-jun & J. Heaverlo

关键词: 中医中药;针灸;脱发
Key words: Chinese medicine; herbs; acupuncture; hair loss

现代医学将脱发分为斑秃、脂溢性脱发、症状性脱发等多种。中医学也有很多记载,如隋代《诸病源候论》称为“鬼舔头”;明代《外科正宗》有油风记载。症状性脱发从中医理论来看,也属于油风范畴,其病因不同,但治疗上有相同的地方。笔者用中医药、针灸治疗脱发150例,疗效显著,现报告如下。

Modern medicine classifies hair loss into many various types; such as alopecia areata, seborrheic alopecia, and symptomatic alopecia. There are also numerous accounts of hair loss in the Chinese medicine classics. For examples, hair loss is called “demon-licked head” in “The Origin and Indicators of Diseases” of the Sui Dynasty. It is recorded as “oil wind hair loss” in “Orthodox Manual of External Medicine” of the Ming Dynasty. According to Chinese medicine theory, symptomatic alopecia should be categorized into “oil wind hair loss”. Although the disease pathomechanisms may vary, there are commonalities within the treatments. The author has treated 150 cases of hair loss with herbs and acupuncture, and achieved notable results. The following is a report of his findings.

•    一般资料

150例患者中男性80例,女性70例,年龄11-46岁。

1. General information
Among the 150 cases, there are 80 males and 70 females. The age ranges from 11 to 46.

•    治疗方法

2.1 中药治疗:健脾祛湿、清利湿热、养血生发为主:白术12g、茯苓12g、泽泻12g、生薏米30g、 升麻12g、丹皮12g、当归12g、川芎12g、鸡血藤15g、干生地12g、熟地12g、柴胡12g、首乌12g、焦三仙45g. 每日一剂,每日二次。湿服;如皮脂溢出过多者加赤石脂12g、侧柏叶12g、猪苓12g;如腰腿酸软、遗精盗汗、夜寐不安,加龙骨12g(先煎) 、牡蛎12g(先煎) 、乌梅12g;气虚加黄芪20g;如突然大把脱落,急躁易怒,加女贞子12g、旱莲草12g、钩藤12g等进行辩证论治。

2. Treatment

2.1 Herbs-  The therapy focuses on the following treatment methods: fortify the spleen, dispel dampness, clear heat, nourish the blood and promote hair growth.
White atractylodes (bai zhu) 12g,  poria (fu ling) 12g,  alisma (ze xie) 12g, coix (yi mi ren) 30g, cimicifuga (sheng ma) 12g, moutan (mu dan pi) 12g, Chinese angelica (dang gui) 12g, chuanxiong rhizoma (chuan xiong) 12g, spatholobus (ji xue teng) 15g, dried rehmannia (sheng di huang) 12g, cooked rehmannia (shu di huang) 12g, bupleurum (chai hu) 12g, flowery knotweed (shou wu) 12g, scorch-fried three immortals (jiao san xian) 45 g.   Cook one dose a day and take twice while it is warm.

If there is too much seborrheic production, add happoysite (chi shi zhi) 12g, arborvitae leaf (ce bai ye) 12g, and polyporus (zhu ling) 12g.

If the patient has lumbar soreness and/or leg achiness, seminal emissions, night sweating, and restless sleep, add dragon bone (long gu) (predecocted) 12g, oyster shell (mu li): 12g (predecocted), and mume fruit (wu mei) 12g.

If the patient has Qi vacuity, add astragalus (huang qi) 20 g.

If there is great hair loss with irritability add ligustrum (nu zhen zi) 12g, eclipta (han lian cao) 12g, and uncaria (gou teng) 12g.

•    针灸法:以养血活血祛风、健脾祛湿生发为主:选穴:百会、风池、足三里、血海、
神门、内关。操作方法:以虚补实泻法针刺,除肝俞、肾俞针刺用补法外,其余配穴按实泄法针刺。

2.2    Acupuncture treatment principles are: quicken the blood, dispel wind, fortify the spleen, dispel dampness, and promote hair growth.

Selection of acupuncture points: GV-20 (one-hundred convergences), GB-20 (wind pool), ST-36 (Leg Three Li), SP-10 (sea of blood), HT-7 (spirit gate), and PC-6 (inner pass).

Manual needling methods should be used to supplement vacuity and drain repletion. Use supplementation method on BL-18 (liver transport) and BL-23 (kidney transport). Use draining method on all other points.

•    疗效标准

痊愈:脱发症状消失,脱发试验阴性;好转:脱发症状减轻,脱发试验阳性;无效:
脱发症状未减,脱发试验阳性。

•    Standard of Curative Effect

Full recovery: the symptom of hair loss disappears, and the test result is negative;
Improvement: the symptom of hair loss is alleviated, and the test result is positive;
No effect: the symptom of hair loss remains the same, and the test result is positive.

•    治疗结果

痊愈140例,好转9例,无效1例。

•    Therapeutic effect:

Full recovery: 140 cases;
Improvement: 9 cases;
No effect: 1 case.

•    病例

王某,男,37岁,脱发2个月,患者自述平素工作紧张,平时皮脂溢出过多。 查:脱
发试验阳性,头皮瘙痒,毛发稀疏,头油多,精神欠佳,神疲乏力,夜寐不安,二便正常,舌淡苔白,脉眩滑。诊断:中医:油风(脾虚蕴湿,湿热互结);西医:脂溢性脱发。治疗以健脾祛湿,清利湿热,养血生发为主。处方:生白术12g、茯苓12g、生薏米30g、川皮解15g、车前子15g、泽泻15g、当归12g、首乌12g、川芎12g、黄芪20g、乌梅20g、羌活12g、升麻12g、黄芩10g、黄连12g、龙骨12g先煎、牡蛎12g、枳壳12g、丹皮12g、焦山楂15g、炒麦芽15g。水煎400ml,每次200ml,早晚两次湿服。配合针灸选穴:百会、风池、三阴交、足三里、血海、神门、内关、肝俞、肾俞、按虚补实泻法针刺,每日一次,治疗3d,症状有所减轻;患者腰酸,头晕,故原方加赤石脂12g、侧柏叶12g、枳壳12g、灸山芋12g,以助除湿行气、补益肝肾。按以上方法治疗22d,症状全部消失,随访三个月,未复发,告痊愈。

5. Case Study

Examination:  Mr. Wang is 37 years old. He has been experiencing hair loss for two months. His work is very stressful. He has a considerable amount of seborrheic production. The test for hair loss is positive. His symptoms include itchy scalp, scant hair, and excessively oily hair. He appears listless, has a lack of strength, and restless sleep. His stool and urine are normal. His tongue is pale with a white tongue fur. His pulse is stringlike and slippery.

Chinese medicine diagnosis: :  “Oil wind hair loss” due to spleen vacuity and damp-heat binding.

Western medicine diagnosis: seborrheic alopecia.  TCM treatment principles should be: fortify the spleen, dispel dampness, clear heat, disinhibit dampness, nourish the blood, and promote hair growth.

Therapy: fresh white atractylodes (sheng bai zhu) 12g, poria (fu ling) 12g, coix (yi mi ren) 30g, rhizoma dioscorea (bi xie) 15g, plantago seed (che qian zi) 15g, alisma (ze xie) 15g, Chinese angelica (dang gui) 12g, flowery knotweed (shou wu) 12g, chuanxiong rhizoma (chuan xiong) 12g, astragalus (huang qi) 20g, mume fruit (wu me) 20g, notopterygium (qiang huo) 12g, cimicifuga (sheng ma) 12g, scutellaria (huang qin) 10g, coptis (huang lian) 12g,  dragon bone (long gu) (predecocted) 12g oyster shell (mu li) 12g, bitter orange (zhi ke) 12g,  moutan (mu dan pi) 12g, scorch-fried hawthorne fruit (jiao shan zha) 15g, stir-fried barley sprout (chao mai ya) 15g.

(Combine herbs and 1200 ml of water).  Decoct in water until 400 ml. remain. Drink 200 ml twice per day.  Drink once in the morning and once in the evening.  Should be consumed warm.

Acupuncture treatment was used in combination. Selections of acupuncture points: GV-20 (hundred convergences), GB-20 (wind pool), ST6 (three Yin intersection), ST-36 (Leg Three Li), SP-10 (sea of blood), HT-7 (spirit gate), and PC-6 (inner pass), BL-18 (liver transport) and BL-23 (kidney transport). Manual needling methods used should be supplement vacuity and drain repletion. Acpuncture is performed once a day.

After 3 days of treatment, the symptoms were alleviated to some extent. The patient also had sore and aching low back and dizziness.  Therefore additional herbs were utilized.  Additions include: halloysite (chi shi zhi) 12g, arborvitae leaf (ce bai ye) 12g,  mix-fried dioscorea (zhi shan yu) 12g.  These additions may help dispel dampness, move the Qi, supplement the liver and kidney.

The symptom completely disappeared after 22 days of treatment.   After 3 months, the symptoms had not returned.

•    讨论

皮肤病虽发于皮肤,但常是和内脏有密切的联系,有诸内必形于外,运用中医理论,
对疾病进行综合分析、归纳、总结,找出皮肤病与肌体内脏的关系,正确的辩证施治,是治疗皮肤病的关键。方中白术、茯苓、生薏米、生侧柏、赤石脂、枳壳、川皮解、车前子、泽泻,健脾行气除湿;升麻、龙骨、牡蛎、乌梅、以收敛固涩、升阳安神、益精开胃;当归、川芎、鸡血藤、首乌、黄芪、丹皮益气养血活血,祛瘀生新;黄芩、黄连清热燥湿,清上焦头目之热;灸山芋补益肝肾;山楂、炒麦芽调理脾胃功能,使枢机功能得以改善;配合针灸针刺,疏通经络,调理脾胃肝肾功能。综观,使气血大和,毛发得以精血充养,则诸症消失。可见中药,针灸联合治疗脱发,疗效快,复发率低。

•    Discussion:

Although skin diseases manifest on the skin, they are often closely related with the viscera. According to Chinese medicine theory, the key to treating skin diseases is to find the relationship between the disease and the viscera, and then to administer treatment according to the pattern. In the therapy, atractylodes (bai zhu), poria (fu ling), coix (yi mi ren), arborvitae leaf (ce bai ye), halloysite (chi shi zhi), bitter orange (zhi ke), rhizoma dioscorea (bi xie), plantago seed (che qian zi), and alisma (ze xie) can fortify the spleen, move the Qi and dispel dampness. Cimicifuga (sheng ma), dragon bone (long gu), oyster shell (mu li), and mume fruit (wu mei) can astringe and secure, upbear the Yang, quiet the spirit, boost the essence and increase the appetite. Chinese angelica (dang gui), rhizome chuanxiong (chuan xiong)  spatholobus (ji xue teng), flowery knotweed (shou wu), astragalus (huang qi), and moutan (mu dan pi) can boost the Qi, nourish and quicken the blood, dispel stasis, and engender the new. Scutellaria (huang qin) and coptis (huang lian) can clear heat, dry dampness, and clear  heat on the head and eyes. Mix-fried dioscorea (zhi shan yu) can supplement the liver and kidney. Hawthorne fruit (shan zha) and stir-fried barley sprout (chao mai ya) can regulate the stomach.   Acupuncture can free the channels, and regulate the spleen, stomach, liver and kidney. The overall effect is to greatly harmonize the Qi and blood so that the hair can be nourished by the essence and blood.