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“伏毒”是匿藏深伏于机体的毒邪，具有伏而不觉，发时始显的特性，常导致疾病缠绵难愈。银屑病复发具有“伏毒”的物质基础，发病机制与“伏毒”的致病机制相吻合。基于“伏毒”理论论治复发性银屑病，提出其复发的宿根在于余毒匿藏，枢纽是伏毒生瘀，结局为热加毒发。因此，在缓解期残余“伏毒”未去之时，重在清解余毒；复发早期皮损隐匿之时，重在活血行瘀；复发期皮损发作之时，重在清热解毒。
Abstract："Fu Du" means Toxin that hides deep in the body, which has the characteristics of being hidden and unconscious, and only appears when it occurs, which often leads to lingering diseases that are difficult to cure.The recurrence of psoriasis has the material basis of "Fu Du",the pathogenesis of which is consistent with the pathogenic mechanism of the disease.Based on the theory of "Fu Du",it is proposed that the root of its recurrence lies in the hiding of residual Toxin, the pivot is Fu Du inducing stasis, and the outcome is Heat inducing Toxin development.Therefore, when the residual "Fu Du" in the remission period has not been removed, the focus is on clearing the remaining Toxin; When the skin lesions are hidden in the early stage of recurrence, the focus is on activating blood circulation to relieve blood stasis; When skin lesions occur during the relapse period, the focus is on clearing Heat and detoxifying.
[1]GRIFFITHS C E M,ARMSTRONG A W,GUDJONSSON J E,et al.Psoriasis[J].Lancet,2021,397(10281):1301-1315.
[2]LEBWOHL M,IVERSEN L,EIDSMO L,et al.Investigation of plaque psoriasis relapse after secukinumab withdrawal in patients from two phase Ⅲ studies[J].Clin Exp Dermatol,2024,49(8):793-800.
[3]UMEZAWA Y,TORISU-ITAKURA H,MORISAKI Y,et al.Long-term efficacy and safety results from an open-label phase Ⅲ study(UNCOVER-J) in Japanese plaque psoriasis patients:impact of treatment withdrawal and retreatment of ixekizumab[J].J Eur Acad Dermatol Venereol,2019,33(3):568-576.
[4]季云润，姚舜语，刘小琨，等.21世纪银屑病中医辨证研究回顾与展望[J].北京中医药，2021,40(8):811-813.
[5]李晓睿，张希琳，李咏梅，等.银屑病从血论治调节T淋巴细胞研究进展[J].中国中西医结合皮肤性病学杂志，2019,18(5):517-520.
[6]江珊，孙萌，陈潇颖，等.国医大师周仲瑛从“伏毒”辨治白血病经验[J].上海中医药杂志，2024,58(2):62-65.
[7]马印尼，张瑞丽.银屑病共病的临床特征及相关危险因素分析[J].临床皮肤科杂志，2022,51(3):147-149.
[8]张颖，郭金竹，张春雷.组织常驻记忆性T细胞与银屑病复发的研究进展[J].中国麻风皮肤病杂志，2022,38(7):493-498.
[9]YANG K,KALLIES A.Tissue-specific differentiation of CD8+ resident memory T cells[J].Trends Immunol,2021,42(10):876-890.
[10]KASPROWICZ-FURMANCZYK M,CZERWINSKA J,PLACEK W,et al.Assessment of the tissue resident memory cells in lesional skin of patients with psoriasis and in healthy skin of healthy volunteers[J].Int J Environ Res Public Health,2021,18(21):11251.
[11]DACCACHE J A,NAIK S.Inflammatory memory in chronic skin disease[J].JID Innov,2024,4(3):100277.
[12]SACZONEK A O,KRAJEWSKA-WLODARCZYK M,KAS-PROWICZ-FURMANCZYK M,et al.Immunological memory of psoriatic lesions[J].Int J Mol Sci,2020,21(2):625.
[13]HOU H,LI J,WANG J J,et al.Abnormal dermal microvascular endothelial cells in psoriatic excessive angiogenesis[J].Microvasc Res,2024,155:104718.
[14]赵文毅，王玲玲，迟金亭.名老中医左振素辨治银屑病关节炎经验[J].江西中医药，2021,52(7):25-27.
[15]韩冰莹，王萍，周水涵，等.基于伏瘀理论从免疫记忆探讨复发性银屑病病机与治疗[J].中国中西医结合杂志，2025,45(4):475-481.
[16]LEIJTEN E F,VAN KEMPEN T S,OLDE NORDKAMP M A,et al.Tissue-resident memory CD8+T cells from skin differentiate psoriatic arthritis from psoriasis[J].Arthritis Rheumatol,2021,73(7):1220-1232.
[17]VO S,WATANABE R,KOGUCHI-YOSHIOKA H,et al.CD8 resident memory T cells with interleukin 17A-producing potential are accumulated in disease-na?ve nonlesional sites of psoriasis possibly in correlation with disease duration[J].Br J Dermatol,2019,181(2):410-412.
[18]BODDUPALLI C S,BAR N,KADAVERU K,et al.Interlesional diversity of T cell receptors in melanoma with immune checkpoints enriched in tissue-resident memory T cells[J].JCI Insight,2016,1(21):e88955.
[19]BOURHIS M,PALLE J,GALY-FAUROUX I,et al.Direct and indirect modulation of T cells by VEGF-A counteracted by anti-angiogenic treatment[J].Front Immunol,2021,12:616837.
[20]CLEMENTE N,RAINERI D,CAPPELLANO G,et al.The Emerging role of neutrophils in psoriatic arthritis:From pathogenesis to therapeutic implications.Frontiers in Immunology[J].Front Immun,2021,12:678569.
[21]刘晓涵，晋红中.银屑病复发的危险因素及机制[J].协和医学杂志，2022,13(2):308-314.
[22]张文娟，韩凌，危建安.从免疫性炎症疾病复发特征试论中医伏邪的生物学基础[J].中国中西医结合杂志，2023,43(2):236-240.
[23]ZHOU Y,LI N,FAN X,et al.Intranasal streptococcal infection exacerbates psoriasis-like dermatitis via the induction of skin tissue-resident memory T cells[J].Biochim Biophys Acta Mol Basis Dis,2023,1869(3):166629.
[24]林永丽，杨灿，郭莹，等.血清白细胞介素-1β及内皮细胞特异性分子-1与寻常型银屑病患者临床预后的关系[J].新乡医学院学报，2025,42(6):472-477.
[25]段逸山.医古文[M].上海：上海科学技术出版社，1984.
[26]王雪松.雷公藤片治疗银屑病的临床观察及其机制研究[D].济南：山东中医药大学，2022.
[27]QIU S W,LV D L.Triptolide inhibits CD4+ memory T cell-mediated acute rejection and prolongs cardiac allograft survival in mice[J].Exp Ther Med,2017,14(4):2817-2822.
[28]COPPOLA C,HOPKINS B,HUHN S,et al.Investigation of the impact from IL-2,IL-7,and IL-15 on the growth and signaling of activated CD4+ T cells[J].Int J Mol Sci,2020,21(21):7814.
[29]王秋月.加味凉血消风散调控皮肤组织常驻记忆CD8+T细胞治疗银屑病的临床及实验研究初探[D].成都：成都中医药大学，2022.
[30]陈朝霞，李萍，张广中，等.艾灸治疗血瘀证斑块型银屑病：随机对照研究[J].中国针灸，2021,41(7):762-766.
[31]陈慧，肖君刚，张勇.姜黄煎剂对银屑病皮损中CD45RO、VEGF和iNOS表达的影响[J].中国中西医结合皮肤性病学杂志，2004,(4):198-201.
[32]刘宇，李萍，王燕，等.活血解毒方通过修复表皮屏障减轻银屑病样小鼠皮损复发表现[J].中国病理生理杂志，2021,37(8):1470-1478.
[33]刘欣，李萍，张蕾，等.养血活血解毒方及其拆方药物血清对佛波酯诱导的血管内皮细胞ERK/NF-κB通路的影响[J].中医杂志，2018,59(16):1410-1415.
[34]DONG C B,LIN L M,DU J.Characteristics and sources of tissue-resident memory T cells in psoriasis relapse[J].Curr Res Immunol,2023,4:100067.
[35]CHEN Y C,YAN Y H,LIU H Z,et al.Dihydroartemisinin ameliorates psoriatic skin inflammation and its relapse by diminishing CD8+ T-cell memory in wild-type and humanized mice[J].Theranostics,2020,10(23):10466-10482.
[36]李晓睿.消银方通过影响T淋巴细胞免疫功能治疗银屑病的机制研究[D].上海：上海中医药大学，2019.
基本信息:
DOI：10.16368/j.issn.1674-8999.2025.09.291
中图分类号:R275.9
引用信息:
[1]赵力,李若楠,李萍,等.基于“伏毒”理论探讨银屑病复发的证治思路[J].中医学报,2025,40(09):1827-1831.DOI:10.16368/j.issn.1674-8999.2025.09.291.
基金信息:
国家自然科学基金项目(82074434); 青年岐黄学者项目{[2022]256号}
2024-11-29
2024
2025-05-21
2025-09-05
2025
1
2025-09-08
2025-09-08