理肠四方治疗溃疡性结肠炎的病机(英文)  

Mechanism of four regulating-intestines prescriptions in the treatment of ulcerative colitis

作　　者：范恒[1] 邱明义[2] 梅家俊[2] 沈关心[3] 刘松林[2] 

机构地区：[1]华中科技大学同济医学院附属协和医院中西医结合科,湖北省武汉市430022 [2]湖北中医学院中医系,湖北省武汉市430061 [3]华中科技大学同济医学院免疫实验室,湖北省武汉市430022

出　　处：《中国临床康复》2006年第43期217-222,共6页Chinese Journal of Clinical Rehabilitation

基　　金：湖北省教委资助项目(99Z014)~~

摘　　要：目的:通过总结前期动物实验结果,分析比较理肠四方(乌梅丸、白头翁汤、参苓白术散、痛泻要方)治疗溃疡性结肠炎疗效。方法:收集笔者近期发表理肠四方治疗溃疡性结肠炎相关文章的结论,分别从动物实验中症状、体征、病理改变、细胞因子及其蛋白表达、血液黏附分子、细胞凋亡及调控基因几方面进行比较,分析溃疡性结肠炎中医的病机和理肠四方的中医作用机制。理肠四方即乌梅丸(出自《伤寒论》《金匮要略》),由乌梅、细辛、干姜、黄连、当归、附子、蜀椒、桂枝、人参(生晒参)、黄柏等药组成,主治蛔厥证又主久利,白头翁汤(出自《伤寒论》),由白头翁、黄连、黄柏、秦皮等药组成,有清热解毒止痢等作用,主治热痢。参苓白术散(出自《太平惠民和剂局方》),由莲子肉、薏苡仁、砂仁、桔梗、白扁豆、茯苓、人参(生晒参)、甘草、白术、山药等药组成,有益气健脾,渗湿止泻之功,主治脾虚泄泻。痛泻要方(来源于《景岳全书》),由白术、白芍、陈皮、防风4味药组成,有舒肝健脾止泻等作用,主治肝旺脾虚、肠鸣腹痛泄泻。结果:①溃疡性结肠炎由于慢性久痢,正气已虚,邪气未尽,其治疗如专事清化导滞则徒伤其正,如一味扶正兜涩则恋邪碍积,唯扶正祛邪是其正治,与乌梅丸的主治相一致。②而白头翁汤以清热燥湿,凉血止痢为主治大法,与本虚为主的溃疡性结肠炎不完全相同。③参苓白术散有益气健脾,渗湿止泻之功,与兼外邪的溃疡性结肠炎亦不完全相同。④痛泻要方主要治疗土虚木乘,脾受肝制,升降失常所致泄泻,虽与溃疡性结肠炎的主要病机脾虚湿盛之脾虚相吻合,但对溃疡性结肠炎缓解期补脾之力较参苓白术散稍弱,故乌梅丸疗效最好,白头翁汤次之,参苓白术散居中,痛泻要方稍差。结论:溃疡性结肠炎可归属于中医“休息痢”范畴,其病机�AIM： To analyze curative effect of four regulating-intestines prescriptions （Wumei Wan, Baitouweng Tang, Shenling Baizhu San and Tongxie Yaofang） on the treatment of ulcerative colitis （UC） through summing up the previous animal experimental results. METHODS： We collected the conclusions in the papers related to four regulating-intestines prescriptions for the treatment of UC which were published recently, made comparisons from the aspects of symptoms, physical sign, pathological change, eytokine and its protein expression, blood adhesion molecule, cell apoptosis and controlling gene and analyzed the pathogenesis of UC and action mechanism of four regulating-intestines prescriptions. Fnur regulating-intestines prescriptions included Wumei Wan, Baitouweng Tang, Shenling Baizhu San and Tungxie Yaofang. Wumei Wan is from Treatise on Exogenous Febrile Diseases and Synopsis of the Golden Chamber, which consists of dark plum, asarum herb, dried ginger, Chinese goldthread, Chinese angelica root, aconite root, pricklyash peel, cassia twig, ginseng （sun-dried ginseng） and bark of cork tree and has marked effect in treating colic caused by ascariasis and persistent dysentery. Baitouweng Tang, from Treatise on Exogenous Febrile Diseases, consists of medicinal herbs such as pulsatilla root, Chinese goldthread, hark of cork tree and ash bark, which has functions of clearing away the heat-evil, expelling superficial evils and relieving dysentery, in addition, it has marked effect in treating heat-type dysentery. Shenling Baizhu San, from Prescriptions of Peaceful benevolent Dispensary, consists of medicinal herbs such as pulp of lotus seed, coix seed, amomum fruit, balloon flower root, white hyacinth bean, poria, ginseng （sun-dried ginseng）, glycyrrhiza, bighead atractylodes and rhizoma dioseoreae, which has the nature of replenishing qi to invigorate the spleen and eliminate wetness to arrest diarrhea and has marked effect on treating diarrhea due to the hypofunction of spleen. Tongxie Yaofang which is fr

关 键 词：结肠炎 溃疡性/中药疗法 中医病因和病机 乌梅丸 白头翁汤 参苓白术散 痛泻要方 

分 类 号：R574.62[医药卫生—消化系统]