基于脾“苦欲补泻”理论从脾阴论治溃疡性结肠炎  

Treatment on ulcerative colitis from the spleen-yin based on the theory of spleen“like or dislike tonifying and purgative”

作　　者：韦鹏飞 胡双元 张怡[1] 李斌[1] WEI Pengfei;HU Shuangyuan;ZHANG Yi;LI Bin(Chengdu University of Traditional Chinese Medicine,Chengdu 610072,China)

机构地区：[1]成都中医药大学,成都610072

出　　处：《北京中医药大学学报》2022年第6期641-644,共4页Journal of Beijing University of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(No.81973821)。

摘　　要：脾“苦欲补泻”理论出自《黄帝内经》,“苦”是脾的病理状态,“欲”是脾的生理状态。湿邪蕴脾,为脾之所“苦”,当以苦味药燥湿而解脾之“苦”。脾阴不足易致脾脏失于和缓之性,失其所“欲”,治则当用甘味药使脾运和缓,复脾之“欲”。溃疡性结肠炎以脾虚为本,湿邪是常见的病理因素。脾虚失健,内生湿邪,湿蕴肠腑,郁而化热,酿生湿热毒邪,灼伤脂络,可致溃疡性结肠炎的发生;湿热毒邪,蕴结不解,耗伤脾阴,或治疗中因用苦燥伤阴、思重伤阴,而致脾失其所欲,气血不濡,肠腑肌肉血络不养,则溃疡性结肠炎经久不愈,遂致病势缠绵。溃疡性结肠炎迁延发展,往往出现湿热与阴伤并存的局面,故而治疗上应清热燥湿解毒与护阴并行,不忘湿,亦不忘阴,润燥同用,以期解溃疡性结肠炎病所之毒邪;复脾之性,脾运和缓,以求其能濡润肠腑,溃疡能愈。The theory of spleen“like or dislike tonifying and purgative”comes from Huangdi Neijing.“Dislike”is the pathological state of the spleen,and“like”is the physiological state of the spleen.Dampness accumulates in the spleen,which is“dislike”for the spleen,and the“dislike”of the spleen should be relieved by drying dampness with herbal medicines with bitter flavor.Deficiency of spleen-yin can easily cause the spleen to lose its tempering nature and lose its“like”.In the treatment,herbal medicines with sweet flavor should be used to calm the spleen and restore the“like”of the spleen.Ulcerative colitis is based on spleen deficiency,and dampness is a common pathological factor.When the spleen is deficient,internal dampness is generated,and the dampness is contained in the intestines and internal organs,which turn into heat,resulting in damp-heat poisonous evil,which burns the fatty ligaments and can lead to ulcerative colitis;damp-heat and toxin,which are not resolved,deplete the spleen yin,or using too many medicines with bitter flavor that damage the spleen-yin,and excessive thinking damages the spleen-yin,cause the spleen to lose its“like”,the blood vessels and muscles are not nourished by qi and blood,then the ulcerative colitis will not be heal for a long time,and the disease will be lingering.It is often the co-existence of damp-heat and spleen-yin deficiency in the late stage of ulcerative colitis,so the treatment should be clearing heat and drying dampness and removing toxin and protect yin,not forgetting dampness and yin,moistening dryness and nourishing yin together,in order to resolve the toxic evil of ulcerative colitis.Restoring the gentle nature of the spleen,allows the qi and blood to moisten the large intestine and ulcers can be healed.

关 键 词：溃疡性结肠炎 苦欲补泻 湿邪 脾阴虚 凉血去湿补阴益气丸 

分 类 号：R356.34[医药卫生—基础医学]