谢晓华基于“调水道,行津液”针药结合治疗单纯性肠梗阻的思路探讨  

XIE Xiao-Hua’s Approach to the Treatment of Simple Intestinal Obstruction with Acupuncture Combined with Chinese Medicine Based on the Method of Dredging Water Passage and Promoting Body Fluid Circulation

作　　者：陈佳芸 张子敬[2] 黄展明 魏纯莉 陈春香 谢晓华(指导)[2] CHEN Jia-Yun;ZHANG Zi-Jing;HUANG Zhan-Ming;WEI Chun-Li;CHEN Chun-Xiang;XIE Xiao-Hua(The First Clinical Medical School of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China)

机构地区：[1]广州中医药大学第一临床医学院,广东广州510405 [2]广州中医药大学第一附属医院,广东广州510405

出　　处：《广州中医药大学学报》2022年第9期2161-2166,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家中医药管理局中医药科学技术研究专项(编号:6-07ZB01)。

摘　　要：单纯性肠梗阻可归属中医“关格”“腹痛”“肠结”范畴。谢晓华教授在气滞血瘀、肠腑热结、气阴亏虚的传统辨证思想基础上,认为单纯性肠梗阻的病位在肠腑,与肺、脾胃、肾、三焦等脏腑相关,病机与津液代谢失常密切相关。其治疗需在通腑、扶正、祛邪的基础上,重视“调水道,行津液”。治疗原则需以通腑、调气与利水并重,兼以扶正、祛邪。单纯性肠梗阻禁食阶段采用针刺治疗以助津液通调,选穴以曲池、小海、梁丘、足三里、血海、阴陵泉为主;单纯性肠梗阻进食阶段中药治疗以调理中焦脾胃,行气利水为法,分为水热证和水寒证辨证,分别以胃苓汤、猪苓汤合枳术汤为基础方,可进一步增强疗效。Simple intestinal obstruction can be classified into Guange(obstruction and rejection),abdominal pain and intestinal obstruction in the field of traditional Chinese medicine.On the basis of the conventional differentiation of simple intestinal obstruction with qi stagnation and blood stasis,heat retention in the intestines and deficiency of qi-yin,Professor XIE Xiao-Hua pointed out that the simple intestinal obstruction is located in the intestinal organs and is correlated with the zang-fu organs of lung,spleen and stomach,kidney and triple energizer,and its pathogenesis is closely related to the disorder of body fluid.The treatment for simple intestinal obstruction should be based on unblocking intestines and supporting healthy qi to eliminate pathogens,and the method of dredging water passage and promoting body fluid circulation should be also emphasized.The therapeutic principle is to unblock intestines,regulate qi and induce diuresis simultaneously,together by supporting healthy qi to eliminate pathogens.In the fasting period of simple intestinal obstruction,acupuncture can be used to promote body fluid circulation,and the acupoints of Quchi(LI11),Xiaohai(SI8),Liangqiu(ST34),Zusanli(ST36),Xuehai(SP10)and Yinlingquan(SP9)are chosen as the main points.In the feeding period of simple intestinal obstruction,Chinese medicine therapy can be adopted for regulating the spleen and stomach in the middle energizer,activating qi and inducing diuresis.And simple intestinal obstruction in the feeding period can be differentiated as water-heat syndrome and water-cold syndrome,which can be treated with fundamental prescriptions of Weiling Decoction,Zhuling Decoction combined with Zhizhu Decoction respectively,so as to further enhance the curative effect.

关 键 词：单纯性肠梗阻 调水道 行津液 针药结合 临床经验 谢晓华 

分 类 号：R574.2[医药卫生—消化系统] R256.33[医药卫生—内科学]