立足脾胃升降不利论治功能性胃肠病  

Treatment of Functional Gastrointestinal Diseases from Perspective of Dysfunction of Spleen and Stomach

作　　者：郭威 顾勤[2] 朱奕琦 GUO Wei;GU Qin;ZHU Yiqi(Nanjing University of Chinese Medicine,Nanjing 210029,Jiangsu,China;Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,Jiangsu,China)

机构地区：[1]南京中医药大学,江苏南京210029 [2]南京中医药大学附属医院,江苏南京210029

出　　处：《实用中医内科杂志》2020年第7期21-24,共4页Journal of Practical Traditional Chinese Internal Medicine

基　　金：国家科学技术部国家“十二五”科学支撑计划(2013BAI02B00)。

摘　　要：功能性胃肠病多见于脾胃气弱者,中气不足,斡旋无力,加之感受外邪,起居失宜,情志不畅,饮食不节等因素诱发疾病的产生,具有发病率高,病程长,易反复等特点,部分患者西医治疗效果欠佳且不良反应明显。笔者在临床中发现立足脾胃升降治疗功能性胃肠病常能取得令人满意的效果。自然界一切生命的更迭变化都有赖于气机的升降出入,而人体亦是如此。脾胃居于人体中焦,在整个升降体系中扮演着重要角色,阴阳气血津液的正常运行有赖于升降协和,脾胃升降不利可直接导致胃肠功能障碍。笔者搜集相关文献典籍,总结出"升阳""辛开苦降""升降结合,因地制宜"是临床常用的调节升降的治法,并举四则验案以证之。脾气主升,而中气是否充足决定了脾升功能的强弱,李东垣尤其重视补益脾胃与升发阳气。辛开苦降法是利用辛、苦两类不同性味的药物,使阴阳和,升降顺,脾胃阴阳升降恢复平衡的一种方法。脾胃升降相辅相成,脾气上升可促使胃气顺降,胃气顺降可促使脾气上升,如圆轮之枢轴运动,循环往复而升降不息,临床处方时应注意升降结合。脾胃系统疾病应根据地域环境的不同而选择适宜的治法、方药。立足于脾胃升降,灵活变通,对提高功能性胃肠病临床疗效有重要的实践与指导意义。Functional gastrointestinal diseases are more common in patients with Qi deficiency of spleen and stomach.Because of insufficient middle Qi,combined with external evil,inappropriate living,poor emotion,disorderly diet and other factors,it would induce thedisease. It has the characteristics of high incidence,long course of disease,easy to repeat and so on. Some patients have poor therapeutic effect and obvious adverse reactions. The author found that the treatment of functional gastrointestinal diseases based on spleen and stomach can often achieve satisfactory results. The change of all life in nature depends on the ascending and descending of Qi,and so does the human body. Spleen and stomach are in the middle Jiao of human body and play an important role in the whole lifting system. The normal function of Yin-Yang,Qi,blood and body liquid depends on the harmony of ascending and descending,and the unfavorable ascending and descending of spleen and stomach can directly lead to gastrointestinal dysfunction. The author collected the relevant literature and classics,and summed up that ascending Yang,opening with pungent drugs and descending with bitter drugs and " combination of ascending and descending according to local conditions" were the commonly used clinical methods to regulate the ascending and descending,and four cases were cited to prove it. Spleen controls the ascending and descending. And whether the middle Qi is sufficientdetermines the ascending function of spleen. LI Dongyuan attached particular importance to tonifying the spleen and stomach and rising Yangqi. The opening with pungent drugs and descending with bitter drugs method is a method to restore the balance of Yin and Yang,descending and ascending. The descending and ascending of spleen and stomach complement each other. The ascending of spleen Qi can promote the smooth decline of stomach Qi,and the decline of stomach Qi can promote the ascending of spleen Qi,like the axis movement of round wheel. Attention should be paid to the combination of a

关 键 词：脾胃升降 功能性胃肠病 益气升阳 辛开苦降 

分 类 号：R256.3[医药卫生—中医内科学]