脾胃病治疗经验概要  

Summary of Experience of Treating Spleen and Stomach Diseases

作　　者：蔡林[1] 杨济铭 王方 雷雪莉 CAI Lin;YANG Ji-ming;WANG Fang;LEI Xue-li(North Sichuan Medical College,Nanchong,Sichuan,China,637000)

机构地区：[1]川北医学院,四川南充637000

出　　处：《河南中医》2021年第11期1687-1689,共3页Henan Traditional Chinese Medicine

基　　金：川北医学院市校合作科研资助项目(19SXHZ0063);四川省科技厅科研资助项目(2019YJ0542);南充市社科项目(YAZX19-Z-02)。

摘　　要：脾胃病证候复杂,治法繁多,纯寒证或纯热证皆少见,多为寒热错杂之证,宜寒凉药与温热药配伍使用,常选用黄芩、黄连配半夏、干姜,吴茱萸配黄连,炮姜、高良姜配黄连等,寒热兼用,但要以偏温热为主。脾以升为健,胃以降为和,脾胃患病,气机升降失衡,致气机紊乱,变证丛生,证属脾不升清者,选益气健脾之品,如葛根、黄芪、升麻、柴胡、桔梗、荷叶等;证属胃气不降者,则选用和胃降气药物,如法半夏、枳实、厚朴、旋覆花、生姜、竹茹等,使脾胃功能以衡为期。肝气对脾胃之气具有疏通和畅达的作用,在健运脾胃的同时,佐以疏肝、柔肝之品,如生麦芽、升麻、柴胡、郁金、香附等调达肝气,可助脾胃功能恢复。治脾勿忘宣肺,肺的宣发有助于脾的升清,肺的肃降有助于胃的降浊,麻黄、桔梗、杏仁、苏叶等宣降肺气之品,可间接促进脾升胃降功能的恢复。难治性脾胃病病变部位已由经脉深入络脉,在辨证的基础上,采用具有通络作用的药物,如降香、沉香、九香虫、檀香、乳香、没药、蒲黄、五灵脂、金铃子、延胡索等行气活血,化瘀止痛,疏通络脉,可提高疗效。The syndromes of spleen and stomach diseases are complex,and there are many treatment methods.Pure cold syndrome or pure heat syndrome is rare.Most of them belong to cold and heat syndrome in complexity,so it is appropriate to use cold and heat drugs together to remove cold and heat syndromes.Huangqin(Radix Scutellariae)and Huanglian(Rhizoma Coptidis)combined with Banxia(Rhizoma Pinelliae)and Ganjiang(Rhizoma Zingiberis),Wuzhuyu(Fructus Evodiae)combined with Huanglian(Rhizoma Coptidis),Paojiang(Rhizoma Zingiberis Praeparatum)and Gaoliangjiang(Rhizoma Alpiniae Officinarum)combined with Huanglian(Rhizoma Coptidis),etc.can be used.Though cold and heat drugs are used together,warm and hot drugs are mainly used.The spleen is healthy by rising,and the stomach is harmonious by falling.If there is something wrong with the spleen and stomach,the ascending and descending of the qi movement will be unbalanced,resulting in the disorder of the qi movement and various deteriorated syndromes.For spleen qi failing to ascend,it is proper to select products for replenishing qi and activating the spleen,such as Gegen(Radix Puerariae Lobatae),Huangqi(Radix Astragali),Shengma,Chaihu(Radix Bupleuri),Jiegeng(Radix Platycodonis),Heye(Folium Nelumbinis),etc.For stomach qi failing to descend,it is proper to select products for harmonizing the stomach and lowering qi,such as Fabanxia(Rhizoma Pinelliae Praeparatum),Zhishi(Fructus Aurantii Immaturus),Houpo(Cortex Magnoliae Officinalis),Xuanfuhua(Flos Inulae),Shengjiang(Rhizoma Zingiveris Recens),Zhuru(Caulis Bambusae in Taenia),etc.to balance the functions of the spleen and stomach.Liver qi can dredge and smooth the qi of the spleen and stomach,so besides invigorating the spleen and stomach,it is proper to supplement with products that soothe the liver and soften the liver,such as Shengmaiya(Fructus Hordei Germinatus),Shengma(Rhizoma Cimicifugae),Chaihu(Radix Bupleuri),Yujin(Radix Curcumae),Xiangfu(Rhizoma Cyperi),etc.to regulate the liver qi and help restore the functions of the spleen and

关 键 词：脾胃病 寒热兼施 燮理升降 疏肝 宣肺 通络 

分 类 号：R256.3[医药卫生—中医内科学]