Lesions of nails and phalanx

Identification and governance

A disease can be caused by a's own disease, systemic disease, a change in the finger, toe A, or a skin disease around a affected finger, toe. Therefore, observing the changes of fingers and Phalanx (especially nails) is of great significance for assisting in the diagnosis and treatment of some diseases, especially some skin diseases. This article focuses on the lesions of skin diseases, and describes the treatment of TCM syndrome differentiation.

I. Physiology of Jia

A is one of the accessories of the skin. It starts to grow in 3 months, and can be formed in about 5 months. The average daily length of A is about 0.1mm. The growth rate of A is affected by a variety of factors, such as faster teenagers and adults than infants and the elderly; faster during the day than at night; faster in spring and summer than in autumn and winter, the growth rate of A is proportional to the length of the finger, that is, the longer the finger, the faster the growth of A. gradually slows down after middle age. It may take about 100 days for the new armor to grow from the root to restore the normal morphology at the margin of the nail if the nail is injured or removed after surgery.

The normal deck can be rectangular, square, or trapezoid. The deck is full, flat and lustrous, with extremely fine parallel longitudinal lines. The average deck length is 12 ~ 13mm, width ranging from 0.5 to thick ~ 0.8mm. Its roots have milky white semi-arc (also called a half-month), which is a new part of the deck. The size varies from person to person. The maximum, index, middle finger, ring finger, and small finger of the thumb are gradually reduced and disappear.

Ii. Lesions of armor

(1) color change

The normal deck should be transparent, and the color of a, except for the lesions of A, mainly depends on the changes of blood vessels in bed. Except for the color change of the deck, the color change of the deck is often caused by the influence of the external environment. Other colors, such as dyeing agents, smoking and chemicals, can change the color of the deck. Generally, no treatment is required for the latter, and the deck color can gradually return to normal without being exposed to the environment.

1. The white armor is displayed as the deck is partially or completely white, and the pressure is not fading. If the deck is spotted, linear, and flake white spot, it is called White Spot Disease. White spots often occur in the half-month of A. As the deck grows, the white spots gradually move forward to the jiayuan. If there is a slight trauma and meridian, and qi and blood cannot benefit, no treatment is required. If it is the primary White Spot, there are often no systemic symptoms. It can also be seen in cardification and deck stratified separation. It is often caused by spleen and stomach discord, damage to the spleen by insects, loss of liver and spleen and can be referred to the tongue, pulse and were used to regulate the spleen and stomach, spleen drive, reconcile the liver and spleen method, xiangsha Yangwei pills [1], FEER pills [2], and Xiaoyao Powder [3] were selected. Others, such as flat Moss, jicus, and arsenic, may also have some white armor, you can refer to other skin lesions or medical history for treatment. If the deck is all white, it is called completely white armor disease, patients often have some congenital diseases, mostly due to lack of innate endowment, a loss of prosperity caused. In addition to the treatment of the original congenital diseases, the application of Heche Dazao pills [4] and Shiquan dabu pills [5] can be used to supplement the congenital deficiency. Other diseases, such as psoriasis and hyperthyroidism, can also have completely white armor. At this time, armor changes are secondary, and other symptoms are primary and secondary, which should be treated based on primary and secondary syndrome differentiation.

2. Black armor shows a black band on the deck or black, gray, or black brown on the deck. The patients with the disease are often accompanied by black armor. Most of the symptoms are life-cycle fire or insufficient kidney water. In addition to the treatment of the original disease, you can combine the methods of warming and supplementing kidney yang or nourishing yin and kidney, and choose zuoguyin [6] and Liuwei Dihuang Pills [7] as the cutting treatment. In addition, the exposure to coal tar, take chlorine and other drugs, or ultraviolet radiation, can appear in the black armor; under a pigment moles, under a junction moles are also manifested as black armor.

3. The green armor turns green in part or all of the deck, and the pressure does not fade. If it is infected with green pus or white species, sometimes the deck can also be green, accompanied by Alpha separation and carcinitis, which is called the Green armor syndrome. It is often caused by external attacks by hot and humid heat. Zhiyi qingrejiedu, dehumidification and tongluo method, which can be divided into five kinds of disinfection drinks [8], Xianfang live drinking [9, use Ruyi Jin Huang San for [10] And Chansu cake [11] for treatment. In addition, long-term contact with soap, wet water, or engaged in color woven women can also have green armor.

4. The deck gradually turns yellow, orange or yellow green. In addition to the elderly due to Qi and blood cannot be raised, the occurrence of degeneration, can also be seen in patients with psoriasis, deck dry thick brown yellow; eczema patients can be stained yellow; carcinitis can make the deck yellow; long-term use of tetracycline can make the deck yellow. Treatment can be performed based on changes in the medical history and peripheral skin lesions. In addition, if the deck is yellow, the edge is black, accompanied by abdominal distension, fatigue, shortness of breath, tasteless diet, face and swelling of the body, the tongue is thin, and so on, known as huangjia syndrome. Due to lack of temper, diet loss or partial taste, resulting in gas damage, should be Jian Spleen Qi method, you can choose to use fuzhongyi qi Decoction [12] and Xiangsha liujun decoction [13] for the treatment.

5. The red armor shows that the deck is red. In fact, it is the congestion of the bed, so the pressure fades. If it occurs after drinking and taking a bath, it is a normal phenomenon; if it is accompanied by high fever, sweating, thirst, red tongue, yellow, pulse large, for hot in gas points, white Tiger soup [14] is optional.

6. The blue-violet armor is shown as the deck Violet, which loses its luster. In fact, it is also the color change of the nail bed, which is reflected through the deck. If it is cold at the end of the limbs, the skin is purple and red, especially in the case of cold, with cold sweat, pale blue and purple tongue, thin and weak, it can be seen in Renault disease, systemic lupus erythematosus, erythema like frostbite, frostbite, artifacia of the limb, hard skin, net blue spot and so on. Mostly from cold condensation Qi stagnation, blocking the context. Zhiyi quhan wenjing, Promoting Blood Circulation and Removing Blood Stasis method, can use Danggui siinverse decoction [15] Cut. Qingzijia can also be seen in the wind and a variety of diseases, can be referred to in the temporary evidence.

7. The bleeding in the lower part of the armor is indicated by vertices or blemishes under the armor, which are purple-red or purple-black. Those who send to the phalanx may rush through the treasure due to trauma or shoes and boots. Those who send to the nail may, except for trauma, suffer from liver fire, hot blood, or spleen blood, as a result, the blood is beyond the pulse, and the stagnation is the spot. In addition to a lower bleeding, often accompanied by irritability, chest tightness, threat expansion, or annoyance restless, hot night or even bloating will be paralyzed, tasteless diet and other symptoms, refer to the tongue and vein changes, and use methods such as clearing the liver fire, cooling blood to stop bleeding, or injecting blood into the spleen, respectively, this paper selected gentian xianggan decoction [16], heat-clearing-Huang Di decoction [17], and Guipi Decoction [18.

(2) morphological changes

1. Brittle split a is characterized by a thin deck, Vertical Split, layered separation, or the source of Self-free deck, cracks occur to the root of. It can be seen in Split a and brittle A-A diseases. It is often caused by liver qi, liver deficiency, blood dryness, kidney water deficiency, fever and Yin, and so on. Often accompanied by chest tightness and threat pain, moss thin pulse string; or vertigo tinnitus, tongue red less Jin, pulse thin string number; or waist sour leg soft, tongue red less Moss, thin Pulse weak; or dry mouth, dry throat, tongue, shaojin and other symptoms, you can choose Shugan LiQi, Nourishing Liver Blood, supplementing kidney water, nourishing yin shengjin and other methods, select Xiaoyao San [3], Yangxue rongjin pills [19], Liuwei Dihuang Pills [7], and Yiwei decoction [20.

2. Dry and thick armor shows thickening of the deck, loss of luster, turbidity and malformed. It can be seen in congenital houjia disease, palmodemat skin disease, Mao Zhou kerhua disease. Both Bloating in naze, modemon and slippery, mostly because of spleen deficiency cannot lose the fluid, wet in the inside and dry out. If the skin is dry, itching and dandruff, most of the blood dry cannot be raised, so that a loss of glory. You can use the spleen-assisted operation or nourishing yin and nourishing blood method to select cangshu cream [21] Or nourishing blood and nourishing skin drink [22. If it appears to be a side of the itch, the height of the day is uneven, there is a Yellow Stain Under the, the loss of luster is gray, dry thick, brittle, or even empty, spread backward, most of them are jichan. If the deck is dry and thick, a bit concave, or both longitudinal ridge, transverse gully, turbidity malformed, even the defect, can be seen in the common type or pustule type psoriasis. Other cases, such as chronic eczema and leprosy, can also have dry and thick armor. It is easy to diagnose and treat based on changes in the medical history and peripheral skin lesions.

3. The deck is soft and thin, and the surrounding area is tilted up, like a spoon. It can be seen in anti-armor (also known as the champion ). Because of poor health, lack of blood or diet, resulting in the lack of source after tomorrow, qi and blood cannot be prolonged, but often no obvious systemic symptoms. For governance when nourishing qi and blood and strengthening spleen and benefiting the stomach, you can choose to use the top ten supplements [5], supplemented by medium qi tang cut [12]. In addition, suffering from psoriasis, dry syndrome, hardware, low hemoglobin anemia, limb fat disease, fungal infection, palmodemat skin disease, hypothyroidism or hyperthyroidism, flat Moss, Renault disease, etc, there may also be anti-armor, and corresponding treatment measures can be taken in combination with the skin lesions and Symptom changes of the surrounding body.

4. the removed armor is shown as the deck is tilted from the free margin, white and empty, and gradually separated from the bed. The activity is painful, but generally it will not exceed half of the deck, so it will not fall off, other symptoms are often not obvious, which can be seen in the case of cardification. Most of them are caused by the loss of blood. According to the theory of "liver primary tendon, qi hua In the Claw", Zhiyi Liver Qi, Rong runclaw, can choose to use Jiawei Xiaoyao pill [23] Cutting.

5. the hook-like armor shows that the deck is gradually thickened, and is a mountain-like bulge, which can be increased to the size of broad bean. The surface is rough and uneven, and the black, black, gray, or black and green areas grow with the deck, bend forward or to the side into a hook, similar to the chicken distance, and the general symptoms are often not obvious, visible in the hook a disease (also known as claw ). Often because of years of high or old disease, because of the cycle of failure, so that the meridian can not smooth up, blood stasis block, a raised. The methods of promoting blood circulation and Removing Blood Stasis can be used to clear the channels and channels. You can use Fuyuan blood circulation decoction [24] And Xuefu blood stasis decoction [25. Other cases, such as trauma, shoes and shoes, TIGO, psoriasis, and psoriasis, can also have a hook, which can be combined with the history and changes in peripheral skin lesions, to treat the primary disease.

6. concave point A is a point sag with a needle tip on the deck. The number of concave points is not fixed, and they are not fused with each other. It is called a concave point (also called a pin-Shaped Nail ). In addition to a few normal people, there are only a few concave spots, which are common in psoriasis, flat Moss, vitiligo, areareata, radiation dermatitis, and other diseases. In combination with the changes in peripheral skin lesions, the primary cause of the disease is to treat the disease.

7. A. X. A. x. Common in fever (such as measles, pneumonia, scarlet fever, etc.), heat damage Yin, Yin blood damage, claw armor loss from glory. Zhiyi ziyin Yangxue, rongrunclaw method, combined with its medical history, can choose to use Yiwei decoction [20], consistently fried [26], Mai Wei Di decoction [27] Cut. In addition, it can also be accompanied by a Heng Gou when suffering from eczema, psoriasis, carcinoma, and biting. In combination with the changes in peripheral skin lesions and medical history, to cure the original disease, the deck will gradually become heavier.

8. longitudinal troughs and longitudinal creden are characterized by significant longitudinal troughs or climbing in the center of the deck. The distal part of the deck may be accompanied by cracks or layers, and the symptoms of the whole body are often not obvious, more common in Middle-line malnutrition. Mostly caused by liver deficiency and blood dryness or blood stasis. With reference to the tongue and vein, you can choose to use Jiawei Xiaoyao Powder [23] And Fuyuan Huoxue decoction [24] to cut the rule by treating Yizi Yanggan blood or promoting blood circulation and collateral. In addition, it can still be seen in trauma, flat moss and other diseases, can be combined with the medical history and peripheral skin lesions and treatment of the primary disease.

9. the performance of the thin armor plate is that the deck is thin, pale, or the deck is short, gradually shrinking, or even missing if it falls off, or is indicated by the finger at birth, and all the nails are missing. It is called the thin armor plate, the small armor plate, and the lack of armor. It can be seen in the absence of a disease, brittle armor disease, Alpha atrophy, decorate a disease, hard skin disease, thin armor, small armor, flat moss and other diseases. Due to lack of innate endowment, deficiency of kidney, liver and sperm, loss of spleen and stomach, prolonged illness and qi and blood, diet is not adjusted, etc., qi and blood are restrained, a loss of glory caused. Methods such as nourishing liver and kidney, supplementing spleen and stomach, and nourishing blood can be used according to the performance of skin lesions on the deck and surrounding body, select consistent frying [26], Liuwei Dihuang Pills [7], Buzhong Yiqi Decoction [12], and Heche Dazao pills [4.

10. phalanx is manifested in the hypertrophy of the finger and toe ends, and the deck is obviously enlarged in the vertical and horizontal directions. It is convex and expanded and bent to the finger and toe tip. It can be seen in hipocladatchia and houpioitis. It is often accompanied by prolonged cough, chest tightness and palpitations, tongue scars, or blue and purple on the limb, and fingers are blurred. Mostly from Qi and blood can not be smooth, blocking the pulse. When treating other existing diseases, you can use the methods of promoting blood circulation and Removing Blood Stasis, such as taohong Siwu decoction [28] And tongqiao Huoxue decoction [29.

11. atrophy A showed that the deck became thinner and even disappeared, but the symptoms of the whole body were not obvious. It is called a atrophy, which can be seen in congenital dysplasia of. Because of the inherent shortage of natural endowment and the loss of excellent blood, the loss of. Zhiyi supplements the essence of the blood method. You can choose to use the Heche dazhi pills [4], ginseng Yangrong pills [30], and other cutting methods. Other cases, such as trauma, leasma, hardware, flat Moss, continuous limb dermatitis, Renault, herpile table skin loose, and Kerma disease, can also be accompanied by a atrophy. The skin lesions should be combined to treat primary diseases.

Iii. Discussion on the Method of Identification

Although the predecessors have discussed the case, it is not systematic. Therefore, the author puts forward a preliminary discussion based on the basic principles of TCM theory.

(1) color and morphology Differentiation

According to previous documents, whether the changes in the color and morphology can be attributed to the changes in the viscera and qi and blood. For example, the changes in the color of a are often not obvious when the disease is in the health score; the disease is in the gas score; the disease is in the camp score; the disease is in the blood score, A multi-purple black or under a bleeding. Qi and blood is abundant, then the first part of the Red and full; Qi and blood stasis, then a green purple or purple, and can be accompanied by hook-like armor, dry thick armor; qi and blood two virtual, then pale and unhua, or flat armor, key-shaped armor, and armor strip; Qi deficiency and blood loss, the armor is pale, with a lower bleeding; Qi Deficiency and gas trap, then the armor is pale, the deck may be stripped, longitudinal ridge, or longitudinal split if the Qi stagnation and gas inversion occurs. If the loss of blood in Tianjin is dry, the deck will be dry and unavailable, even dry, dry, and cracked.

(2) Differentiation of causes

According to the characteristics of the disease, the cause of the disease is differentiated. Feng Xie Yu, a color more light red or blue and purple, the deck can be stripped, brittle split, dry thick; Han Xie Yu, a pale, purple, and there may be shrinking armor, thin small armor, lack of armor, and fingers, toe side cold; fire, heat evil, then A Red, Red, even a bleeding, it can also have a brittle split or dry and thick deformation; wet Xie Yi, then a color pollution yellow, turbid, and can appear deck thickening or longitudinal transverse groove lines, even the deck off, a bed erosion infiltration; dry evil, the deck is dry, not Ze, or even brittle split, dry thick; insects evil, the deck can occur white spots, macula, and dry thick, empty or even missing.

(3) syndrome identification of viscera and meridian

The inner connection between armor and viscera was mostly confined to liver discussion. I believe that the twelve meridians of the hand and foot start or stop near the finger and toe plate. The lesions of the viscera are reflected in the deck or bed a. Although they are extremely subtle changes, they are also meaningful. Serious illness and long illness are even more important. Therefore, can you refer to the five-Round eight-Silhouette theory of Tongue Diagnosis and ophthalmology of traditional Chinese medicine to explore the corresponding parts of the viscera on. For example, the anterior part of a indicates the upper focal heart and lung, the middle part indicates the center focal spleen and stomach, and the root part indicates the lower focal liver and kidney (or both sides represent the liver and gallbladder, and the root part indicates the kidney ). Observe the color and morphology of the corresponding parts to know the changes.

The above is only a preliminary discussion of the method of identification of A. Temporary evidence can be used as a reference for the overall treatment of syndrome differentiation. This is not only applicable to dermatology, but may also be of reference value to other subjects.

Appendix

[1] Xiangsha Yangwei Pill ("Miscellaneous origin and origin rhinoceros candle") xiangfu amroyan muxiang zhishi Dazao

[2] feer Pill ("da Ping Huimin and agents Bureau") shenqu Huanglian meat carton used to stir-fry malt betel nut muxiang

[3] Xiaoyao Powder ("Taiping Huimin") Bupleurum Danggui Baizhu baishao Fuling zhigan zomang mint

[4] Heche Dazao Wan ("Jingyue quanshu") Zihe chelaile turtle plate Huangbai Eucommia ox knee tiasepan magimaspart

[5] shiquandabuwan

[6] zuoguyin ("Jingyue quanshu"): yam, Chinese wolfberry, yam, And Yam

[7] Liuwei Dihuang Pills ("xiao'er zhizhijue ")

[8] Five-flavor disinfectant drink ("medical sect jinjian") honeysuckle wild chrysanthemum dandelion purple Earth Ding zibeitiankui

[9] Xianfang life-saving drink ("") pangolin White Peony days pollen soap angle thorn when back to the end of the licorice chishao milk fragrance no medicine windproof peganium chenpi honeysuckle

[10] Ruyi Jinhuang San ("surgical authentic") tianypollen Huangbai rhubarb turmeric baizhi Houpu Chen Piao cangshu Tian nanxing

[11] bucket cake ("choose all") camphor cinnabar bucket crispy milk fragrance unyao xionghuang Ba bean cream light powder musk cold water stone dry slice loudan snail mail

[12] Buzhong Yiqi Decoction ("Spleen and Stomach Theory") astragalus-extract-and-extract-from-the-root ginseng, Angelica, and Angelica

[13] Xiangsha liujun Tang ("add ten thousand disease rejuvenation") xiangfu Baizhu Fuling Jiangxia chenpi white carton Magnolia sand kernels ginseng wood xiangyi Zhi Ren zhigan ginger Jujube

[14] Baihu Decoction ("the theory of typhoid fever") Shengshi zhigan Zhimu glutinous rice

[15] Danggui four against Decoction ("the theory of typhoid fever") Danggui Guizhi Shaoyao xiasan zhigan tongcao Dazao

[16] Longdan xianggan Decoction ("rankroom secret") Longdan grass shengdi Danggui Bupleurum cheqianzi zexiecong

[17] heat-clearing Huang Di Tang (formerly Xijiao Huang Tang, from Qianjin fang) shenghuang Dan PI chishao

[18] Guipi Tang () ginseng, Atractylodes, Astragalus, longeye meat, Angelica, jujube kernels, muxiang, ginger, and jujube

[19] Yangxue rongjin Pills (Beijing drug standards) Danggui chishao weilingxian songjie Baizhu chixiaodou chicken blood vine continuous broken stretch tendon grass tonic bone fat Chen pig he Shouwu mulberry parasitic pig Dangshen muxiang

[20] Yiwei decoction ("Identification of temperature diseases") sharn macaspart shengdi bingtang Yuzhu

[21] cangshu Ointment ("jinzheng jinjian") cangshu honey

[22] nourishing blood and nourishing skin drink ("surgical evidence and treatment book) Danggui Shengma soap-angle thorn shengdi-Huang

[23] Jiawei Xiaoyao Pill ("review Yao Han") Danggui baidao baiyao baixiao Bupleurum gardenia danpi

[24] Fu Yuan Huoxue Decoction ("medical invention") Bupleurum pollen Angelica safflower and licorice pangolin rhubarb peach kernels

[25] Xuefu Zhiyu Decoction ("change the forest") Danggui beef knee safflower shenghuang taoren taobi Busi chishao saignig Platycodon root chuanqi

[26] continuous frying ("Continuing Medical Treatment ")

[27] Mai Wei Dihuang Wan ("Shou shibao yuan") shengdi shanzhi meat yam Fuling danpiezixia huaspart

[28] taobaohong siwutang ("Health Care jinjian") Danggui chishao shengdi chuanqi chuanren safflower

[29] tongqiao Huoxue Tang ("correction of Medical Forest") chishao chuanqi peach kernels safflower ginger old scallions jujube musk

[30] ginseng Yangrong Pill ("da Ping Huimin" and "dose Bureau") baishao Danggui chenpi Huangqi guizhen ginseng baishu Zhizhi