基于“气虚宜掣引之”理论探讨慢传输型便秘的治疗  

A study on treating slow transit constipation based on the theory of “Qi-deficiency shall be invigorated for ascending”

作　　者：张杰 薛晓东[2] 王翠侠 Zhang Jie

机构地区：[1]北京市朝阳区东风社区卫生服务中心,北京100016 [2]天津中医药大学第二附属医院,天津300193

出　　处：《中医临床研究》2021年第22期72-74,共3页Clinical Journal Of Chinese Medicine

摘　　要：文章基于《黄帝内经》"气虚宜掣引之"理论探讨"掣引"之法治疗慢传输型便秘(Slow Transit Constipation,STC)。"掣引"之法是指采用挽回、导引阳气上升,补其气而升其阳的治疗方法,在因虚致实、本虚标实的情况下,达到调畅气机,补而不滞,以补为通的目的。STC病位在大肠,病因病机复杂,与肺、脾、肾关系密切,以肺脾肾三脏亏虚为本,肠腑糟粕积滞互结为标,认为脾失健运、气机壅滞为本病发生的始动因素,肺失治节、宣肃失司、肾不纳气、气化失权是该病发展的关键。若单纯使用补益之剂,恐有壅滞气机、留邪、恋邪之弊,故治宜用"掣引"之法。根据张介宾对"掣引"的释义,具体治疗通过提掣肺气、调节宣肃、温补脾气、调畅气机、温肾纳气、以补为通的方法掣引肺脾肾之气,以达到扶正祛邪、改善便秘症状、增强胃肠蠕动,进而恢复大肠传导功能的目的。The study is on the treatment of slow transit constipation based on the theory of “Qi(气)-deficiency shall be invigorated for ascending” cited from Huangdi Neijing(《黄帝内经》).The method of “invigorated for ascending” refers to the treatment method of recovering and guiding Yangqi(阳气) to rise and supplementing Yangqi to achieve the purpose of regulating Qi,supplementing but not stagnating,and promoting circulation by supplementing yang under the conditions of deficiency in origin and enrichment in symptom.Slow transit constipation is located in the large intestine,and the etiology and pathogenesis are complex and closely related to the lungs,spleen and kidney.Its origin lies in the deficiency of lungs,spleen and kidneys,and the stagnation of intestinal dross is the symptom.The stagnation of intestinal dross is considered as the initiating factors of the disease and the main causes are as follows:the loss of lung’s management of regulation;impaired and descending lung-Qi;deficiency of kidney-Qi failing to control respiring Qi;and failure in Qi transformation.If the use of supplements is obstructing Qi and has the disadvantages of lingering pathogen,it is advisable to adopt the method of “invigorating Qi for ascending”.According to Zhang Jiebin’s interpretation of “invigorating Qi for ascending”,the specific treatment shall follow the methods of invigorating and regulating lung-Qi,warming and tonifying spleen,adjusting Qi,warming kidney to absorb Qi,and replenishing spleen and kidney-Qi to achieve the purpose of invigorating pathogenic factors,improving constipation symptoms,and restoring the conduction function of large intestine.

关 键 词：慢传输型便秘 气虚 肺 脾 肾 

分 类 号：R256.35[医药卫生—中医内科学]