象思维视角下治水思想对泻剂结肠辨治的启发  

Enlightenment of water governance on differentiated treatment of cathartic colon from the perspective of Xiang Thinking

作　　者：何友成 杭露 周淳宇 李思汉 袁建业 HE Youcheng;HANG Lu;ZHOU Chunyu;LI Sihan;YUAN Jianye(Institute of Digestive Diseases,Longhua Hospital,Shanghai University of Chinese Medicine,Shanghai 200032,China;Johns Hopkins University,Baltimore 21218,USA)

机构地区：[1]上海中医药大学附属龙华医院/脾胃病研究所,上海200032 [2]约翰斯·霍普金斯大学,美国马里兰州巴尔的摩21218

出　　处：《湖南中医药大学学报》2022年第10期1715-1719,共5页Journal of Hunan University of Chinese Medicine

基　　金：上海市“科技创新行动计划”医学创新研究专项项目(21Y11922600)。

摘　　要：泻剂结肠是消化系统难治疾病之一,临床治疗常陷入困局。象思维影响着中医药理法方药的构建。基于象思维,从治水思想理解泻剂结肠的病机内涵,认为阴津亏虚、气血不足、阳虚精亏、痰湿郁阻、气滞血瘀、三焦病变等环节参与了泻剂结肠的发生发展,并结合治水思想,构建泻剂结肠的证治思路,选用增液汤合五仁丸化裁“养阴生津、增水行舟”,补中益气汤合黄精、熟地黄“益气补血、束水攻沙”,济川煎、加味肾气丸以“温阳益精、破冰防凌”,平胃散、半夏泻心汤、五苓散诸方“化痰除湿、疏川导滞”,血府逐瘀汤“理气活血、扬风助澜”。同时,根据临床实际,重视“三焦并治、正本清源”的“多脏腑”协同、“多治法”并用的综合治疗思路,旨在为本病临床辨治拓宽思路。Cathartic colon,one of the treatment-resistant diseases for digestive system,is usually difficult to cure.Xiang Thinking influences the construction of TCM principle-method-formula-medication.Based on Xiang Thinking,we tried to understand the pathogenesis of cathartic colon from the idea of water governance and concluded that yin-fluid deficiency,qi-blood deficiency,yang-essence deficiency,phlegm-damp stasis,qi stagnation and blood stasis,and pattern transmission along the three jiao,etc.were involved in the occurrence and development of cathartic colon.Combined with the idea of water governance,we constructed the following treatment principles.We selected Zengye Decoction with Modified Wuren Pill to"nourish yin,generate fluid to promote bowel movements",Buzhong Yiqi Decoction with Huangjing(Rhizoma Polygonati)and Shudihuang(Prepared Rehmannia Root)to"invigorate qi and nourish blood,control water to cure constipation",Jichuan Decoction and Modified Shenqi Pill to"warm yang and nourish essence,attack and prevent cold",Pingwei Powder,Banxia Xiexin Decoction and Wuling Powder to"resolve phlegm and dampness,soothe the stasis",and Xuefu Zhuyu Decoction to"regulate qi and activate blood,promote the movements".Meanwhile,we put emphasis on the comprehensive treatment by collaboration of"multiple zang and fu organs"and"multiple methods"in accordance with"treating triple jiao together,identifying the root and clearing the source",aiming to enrich the differential treatments for cathartic colon.

关 键 词：便秘 中医药 象思维 泻剂结肠 治水思想 三焦 增水行舟 

分 类 号：R256.35[医药卫生—中医内科学]