中医名方从脾论治儿童功能性腹痛的临床应用  

Clinical application of famous prescriptions of TCM in treating children's functional abdominal pain from the spleen

作　　者：张旭[1,2] 李梅芳 胡思源[1,2] 钟成梁 ZHANG Xu;LI Meifang;HU Siyuan;ZHONG Chengliang(Clinical Trials Center,The First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin,300381,China;National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion,Tianjin,300381,China)

机构地区：[1]天津中医药大学第一附属医院临床试验中心,天津300381 [2]国家中医针灸临床医学研究中心,天津300381

出　　处：《中医儿科杂志》2023年第2期4-6,共3页Journal of Pediatrics of Traditional Chinese Medicine

基　　金：国家重点研发计划中医药现代化研究重点专项课题(2018YFC1708106)。

摘　　要：功能性腹痛的基本病机包括寒凝气滞、乳食积滞、肝气乘脾和脾肾阳虚。不论是寒邪、食积、肝郁所致的“不通则痛”,还是脾虚、脾肾阳虚引起的“不荣则痛”,发病机制均与脾胃相关。中医名方治疗本病多从脾论治。寒凝气滞者,当温中散寒、理气止痛,临床可用良附丸合正气天香散或养脏散加减;寒湿阻滞者,可用藿香正气散解表化湿、理气和中;乳食积滞者,可用香砂平胃散或保和丸消食导滞,可酌添理气药以助脾胃运化;肝气乘脾者,可用四逆散、四君子汤加味、柴胡疏肝散或逍遥散等疏肝健脾、行气止痛,注意情感疏导;对于虚寒腹痛者,可用小建中汤、理中丸或调中丸温补脾阳、散寒止痛。The basic disease mechanisms of functional abdominal pain(FAP)include cold coagulating qi stagnation,milk and food retention,liver qi invading the spleen and spleen kidney yang deficiency.The pathogenesis is related to the spleen and stomach,regardless of the“pain from obstruction”caused by cold,food retention,and liver depression or“pain from malnutrition”caused by yang deficiency of the spleen and kidney,many famous prescriptions of TCM deal with FAP from spleen.Those who are in cold coagulation qi stagnation,should be treated by warming middle burner and dispelling cold and regulating qi to relieve pain,so they can be clinically treated with Liangfu Wan(良附丸)combined with Zhengqi Tianxiang San(正气天香散)or modified Yangzang San(养脏散),and those who are in cold dampness block can be treated with Huoxiang Zhengqi San(藿香正气散)to relieve superficies and humidifying,and regulating qi and invigorating middle burner;for those who suffer from milk and food retention,Xiangsha Pingwei San(香砂平胃散)or Baohe Wan(保和丸)may be used to dissipate the stagnation,and medicines regulating qi may be added to help spleen and stomach transport;when the liver qi is attacking spleen,medicines such as Sini San(四逆散),modified Sijunzi Tang(四君子汤),Chaihu Shugan San(柴胡疏肝散)or Xiaoyao San(逍遥散),can be used to soothing liver and invigorating spleen and decouple qi and relieve pain,with attention to emotional grooming;for patients with abdominal pain of weakness type,treatment can be performed with Xiaojianzhong Tang(小建中汤),Lizhong Wan(理中丸)or Tiaozhong Wan(调中丸)to warm and nourish the spleen yang and dissipate cold for pain relief.

关 键 词：功能性腹痛 儿童 从脾论治 临床应用 

分 类 号：R256.33[医药卫生—中医内科学]