单兆伟膏方辨治慢性功能性便秘的经验探析  

Discussion on SHAN Zhaowei′s Experience on Treating Chronic Functional Constipation with Ointment

作　　者：贺怡宁 吴星星 刘增巍[1] 赵崧[1] HE Yining;WU Xingxing;LIU Zengwei;ZHAO Song(Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,Jiangsu,China)

机构地区：[1]南京中医药大学附属医院,江苏南京210029

出　　处：《辽宁中医杂志》2023年第1期34-36,共3页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(81774243)。

摘　　要：慢性功能性便秘病程迁延复杂,多见于老年人,病机以虚证为主。单兆伟教授临证数十载,对消化系统疾病有着独到见解和用药体会,他认为膏方兼具补虚治本、祛除病邪、口感较佳等特点,尤适用于久秘体虚之人。单兆伟教授主张久秘之根、本在于脾胃与肾,重视先后天之本的调补,为大肠顺降糟粕功能正常运行提供重要保障;针对久秘易虚、久秘多变的特点,强调临证应详辨气血阴阳之虚损,兼顾标本虚实寒热之夹杂,辨明主次,随证施补。治法上主张畅达气机,以通为用,从脾胃、肺、肝论治,调和中焦气机以通上达下,宣发肺气以顺降糟粕,疏畅肝气以消除积滞;同时依据久病兼瘀的特点,重视通络祛瘀以行气通腑。组方构药方面注重布局严谨,分清君臣佐使,考究辅料胶品,用药力求性平和缓,以药味之偏性调节人体阴阳之平衡,全面兼顾,综合调理。经多年临床实践与经验积累,单兆伟教授运用膏方治疗慢性功能性便秘颇有心得,疗效显著。并附验案一则进行分析。Chronic functional constipation has prolonged and complex course.It is more common in the elderly.Its pathogenesis is mainly due to deficiency syndrome.Professor SHAN Zhaowei has been engaged in clinical practice for decades and also has unique opinions and medication experience on digestive system diseases.He believes that the ointment has the characteristics of tonifying the deficiency,treating the root causes,dispelling pathogenic factors and better taste.It is especially suitable for people with chronic constipation and weak body.Professor SHAN Zhaowei advocates that spleen,stomach and kidney are the root causes of chronic constipation.Paying attention to prenatal and postnatal constitution provides an important guarantee for the normal functional operation of the descending dross of the large intestine.According to the disease’s characteristics of easily insufficiency and changeable,he emphasizes clearly differentiating Qi,blood,Yin and Yang,combining both the root cause and manifestations,deficiency and excess,cold and heat,distinguishing primary and secondary symptoms,implementing reinforcement after syndrome differentiation.In terms of the treatment for chronic constipation,he stresses regulating Qi activity and dredging method and treating from spleen,stomach,lung and liver,such as diffusing and descending lung Qi to reduce the turbid,soothing liver Qi to eliminate accumulation.At the same time,according to the characteristic of blood stasis after long-time illness,he pays attention to resolving the stagnation,removing blood stasis and clearing collaterals to move Qi and dredge Fu-organs.His prescription has a rigorous structure which distinguishes monarch,minister,assistant and envoy drugs,also strictly utilizes accessories and gelatinous Chinese medicines.He insists the idea of using the medicine mildly and lightly,balancing Yin and Yang of the body with the property of medicine,giving comprehensive consideration and regulation.With years of clinical practice and experience,Professor SHAN Zhaowei has

关 键 词：单兆伟 膏方 慢性功能性便秘 

分 类 号：R256.35[医药卫生—中医内科学]