基于“脾胃虚则九窍不通”理论探讨分泌性中耳炎的论治新思路  

New treatment of secretory otitis media based on the "Nine orifices obstruction caused by spleen-stomach deficiency"

作　　者：房永健 梁俊薇[2] 韩秀丽[2] FANG Yongjian;LIANG Junwei;HAN Xiuli(The First Clinical Medical College of Shandong University of Chinese Medicine,Jinan,Shandong 250355,China;Department of Otolaryngology,The Hospital of Shandong University of Chinese Medicine,Jinan,Shandong 250014,China)

机构地区：[1]山东中医药大学第一临床医学院,山东济南250355 [2]山东中医药大学附属医院耳鼻喉科,山东济南250014

出　　处：《湖南中医药大学学报》2023年第2期359-362,共4页Journal of Hunan University of Chinese Medicine

基　　金：山东省中医药管理局项目(2020-03)。

摘　　要：以“脾胃虚则九窍不通”理论为基础,从中医辨证论治的观点出发,探索脾胃与耳窍之间存在密切的生理、病理联系,发现分泌性中耳炎的病机发展规律与“脾胃虚”有关。分泌性中耳炎主要是鼓室内被痰饮之物潴留所致,鼓室积液是其突出的病理特征。人体脾胃虚弱,影响水通道蛋白的正常表达,造成中耳积液及中耳黏膜水肿。基于上述理论特点,提出中医特色治疗方法,以健旺脾胃为本,恢复脾胃气机升降为关键,配合祛湿、化痰、活血、行气等治法,如“健脾和胃,祛湿化浊”“调理气机,升清降浊”“行气活血,祛瘀通窍”“甘润降胃,清火化痰”等,以期为提高分泌性中耳炎临床疗效提供一定的帮助。On the basis of "Nine orifices obstruction caused by spleen-stomach deficiency" theory and treatment based on pattern differentiation in Chinese medicine, this study has explored the close physiological and pathological relation between spleen-stomach and ear orifice and it has revealed that the pathogenesis of secretory otitis media is related to "spleen-stomach deficiency". Due to the accumulated phlegm and drink in the drum chamber, the tympanical effusion is a prominent pathological feature, which in turn causes spleen-stomach deficiency, affecting the normal expression of aquaporin, leading to the middle ear effusion and middle ear mucosa edema, and eventually secretory otitis media occurs. Based on the above, the Chinese medicine treatment method is proposed, which mainly strengthens the spleen and stomach, restores the rise and fall of the spleen-stomach qi mechanism. It has been combined with dispelling dampness, eliminating phlegm, promoting blood circulation, and circulating qi.The treatment methods include "invigorating the spleen and stomach, removing dampness and transforming turbidity" "regulating the qi mechanism, ascending nutrients and descending turbidity" "activating qi and blood circulation, removing blood stasis and opening the orifices" "moistening the stomach, clearing fire and transforming phlegm", etc. This study aims to improve the curative effects of secretory otitis media.

关 键 词：分泌性中耳炎 九窍不通 脾胃虚弱 气机升降 痰 水通道蛋白 

分 类 号：R276.1[医药卫生—中医五官科学]