从气、血、水论治肝硬变腹水  

On Treating Liver Cirrhosis Ascites Based on Qi,Blood,Water Theory

作　　者：翟怀乐 周晓玲[2] ZHAI Huai-le;ZHOU Xiao-ling(Guangxi University of Chinese Medicine,Nanning,Guangxi,China,530001;Liuzhou Hospital of Traditional Chinese Medicine Affiliated to Guangxi University of Chinese Medicine,Liuzhou,Guangxi,China,545001)

机构地区：[1]广西中医药大学,广西南宁530001 [2]广西中医药大学附属柳州市中医院,广西柳州545001

出　　处：《河南中医》2020年第10期1478-1481,共4页Henan Traditional Chinese Medicine

基　　金：柳州市科技局智慧健康课题项目(02.01.0035)。

摘　　要：肝硬变腹水的主要病机在于气(阳)虚、血虚、血瘀、水停。气(阳)虚则推动及生化无力,导致血虚、血瘀、水停;水停日久,可导致气血生成不足;血瘀日久,可导致新血不生及水停加重。临证治疗以气、血、水三者关系为核心,从气(阳)、血、水论治,每获良效。阳虚水盛夹瘀证多为臌胀病初中期,治以温补脾肾、化气利水、活血化瘀,方选四逆汤合补阳还五汤合五苓散加减;阳虚血虚水盛证多为臌胀病中后期,治以温补脾肾、化气利水、养血柔肝,方选四逆汤合当归芍药散加减。The main pathogenesis of cirrhotic ascites is qi(yang) deficiency,blood deficiency,blood stasis and water retention.Deficiency of qi(Yang) leads to weakness of propulsion and biochemistry,resulting in blood deficiency,blood stasis and water retention.Long-time water retention can lead to the deficiency of qi and blood.Long-time blood stasis can lead to failure in generating new blood and water retention aggravating.In clinical practice,the relationship between qi,blood and water is the core of the treatment,and good results are often obtained.The syndrome of yang deficiency and water excess combined with blood stasis usually appears in the early and middle stages of tympanic disease.It should be treated by warming and tonifying spleen and kidney,transforming qi and promoting diuretic,promoting blood circulation and removing blood stasis;Frigid Extremities Decoction combined with Yang-Supplementing and Five-Returning Decoction and Modified Five Substances Powder with Poria can be adopted.Yang deficiency and blood deficiency and water excess syndrome usually appears in the middle and later stages of tympanic disease.It should be treated by warming and tonifying spleen and kidney,transforming qi and promoting diuretic,nourishing blood and softening liver;Frigid Extremities Decoction combined with Modified Chinese Angelica and Peony Powder can be adopted.

关 键 词：肝硬变腹水 “气、血、水”理论 阳虚水盛夹瘀证 阳虚血虚水盛证 

分 类 号：R259.752[医药卫生—中西医结合]