该文基于津血同源理论，揭示特应性皮炎（AD）的核心病机为津血输布与转化异常，与肺脾肾功能失常密切相关。结 合现代医学对免疫调节及皮肤屏障功能的研究，提出AD发病之初期，因其先天禀赋不足，后天失养，脾肾不足，肺卫失于 固护，外邪郁于肌表，进而“肺主皮毛”功能失常，津液输布失常，气血运行受阻，郁于肌肤，而生渗出之湿，湿郁而化 热，针刺以清肺宣郁、布津畅络为主；中后期肺病及脾肾，针刺应以补益脾肾、养血润燥为主，同时应标本兼顾。针对顽 固瘙痒，可采用火针、刺络拔罐的方式来治疗，以控制瘙痒，减少复发。

Based on the theory of “body fluid and blood sharing the same origin”，this paper reveals that the core pathogenesis of atopic dermatitis（AD） lies in the abnormal distribution and transformation of body fluid and blood， which is closely related to dysfunction of the lung，spleen，and kidney. Integrating modern medical research on immune regulation and skin barrier function， we propose that in the early stage of AD， due to deficient endowment， acquired loss of nutrition，insufficiency of the spleen and kidney，and failure of the lung-defense system to protect， external pathogens stagnate in the fleshy exterior. This leads to dysfunction of the lung’s governance over the skin， impaired distribution of body fluid， obstruction of qi and blood circulation， and stagnation in the skin， resulting in exudative dampness. The dampness stagnates and transforms into heat. Acupuncture should primarily focus on clearing the lung， dispersing stagnation， distributing body fluid， and unblocking collaterals. In the middle and late stages，as lung disease affects the spleen and kidney，acupuncture should emphasize supplementing and tonifying the spleen and kidney，nourishing blood，and moistening dryness， while simultaneously addressing both the root and the branch. For intractable pruritus，fire needling or prickingcollateral cupping can be employed to control itching and reduce recurrence.

R246.9

广东省中医药局面上资助项目(编号：20222192）