基于《伤寒论》六经辨证治疗功能性腹泻  

Treating Functional Diarrhea by Syndrome Differentiation of Six Meridians Based on Treatise on Cold Damage

作　　者：严宁娟[1] 苏晓兰[1] 张栓宝 独思静 杨俭勤[1] 史海霞[1] 魏玮[1] YAN Ningjuan;Su Xiaolan;ZHANG Shuanbao;DU Sijing;YANG Jianqin;SHI Haixia;WEI Wei(Department of Gastroenterology,Wangjing Hospital,Chinese Academy of Traditional Chinese Medicine/Beijing Key Laboratory of TCM Diagnosis and Treatment of Functional Gastrointestinal Diseases BZ0374,Beijing 100102,China;Department of Traditional Chinese Medicine,Xidian Group Hospital,Xi’an 710077,China)

机构地区：[1]中国中医科学院望京医院脾胃病科/功能性胃肠病中医诊治北京市重点实验室BZ0374,北京100102 [2]西电集团医院中医科,陕西西安710077

出　　处：《山东中医药大学学报》2022年第6期689-693,共5页Journal of Shandong University of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(编号:81774066、81973638)。

摘　　要：《伤寒论》记载的下利、泄利,与现代医学的功能性腹泻类似。基于《伤寒论》辨治下利、泄利学术思想分析相关条文发现,六经皆可见下利和(或)泄利,张仲景分别从疏肝健脾、健脾益气、清热化湿、辛开苦降、温补脾肾、分利小便等方面进行辨治;且除六经外,此类疾病还有表里合邪、虚实夹杂、寒热互见、阴阳参错的复杂情况;此外,张仲景治疗时首先辨阴阳表里寒热虚实,而后抓主症,随证治之。因此,运用经方治疗功能性腹泻时,应探求经旨,不必拘泥,以使经方更好地服务于临床。Xia Li and Xie Li recorded in the Treatise on Cold Damage are similar to functional diarrhea in modern medicine.By analyzing the articles based on the academic thoughts of differentiation and treatment of Xia Li and Xie Li in Treatise on Cold Damage,Xia Li and(or)Xie Li can be seen in six meridians in Treatise on Cold Damage.ZHANG Zhongjing differentiated and treated“Xia Li”from the aspects of soothing liver and invigorating spleen,invigorating spleen and replenishing qi,clearing heat and resolving dampness,pungency opening and bitter discharging,warming and tonifying spleen and kidney,promoting urination.In addition to the six meridians,there are also complicated conditions of diseases involving both exterior and interior,deficiency-excess in complexity,cold-heat complex and intermingling yin and yang.Besides,ZHANG Zhongjing first differentiated yin and yang,exterior and interior,cold and heat,deficiency and excess in the treatment of“Xia Li”,and then grasped the main syndrome and treated it based on syndrome differentiation.Therefore,classical formulas should be used flexibly according to the classical meanings in the treatment of functional diarrhea so as to provide good ideas for the clinical practice.

关 键 词：《伤寒论》 功能性腹泻 疏肝健脾 健脾益气 清热化湿 辛开苦降 温补脾肾 分利小便 

分 类 号：R256.34[医药卫生—中医内科学] R222.2[医药卫生—中医学]