辨治溃疡性直肠炎验案一则  

A case study of treating ulcerative proctitis based on syndrome differentiation

作　　者：张丽琼 刘秋江[2] ZHANG Liqiong

机构地区：[1]福建中医药大学,福建福州350122 [2]福建中医药大学附属泉州中医院,福建泉州362000

出　　处：《中医临床研究》2023年第20期124-127,共4页Clinical Journal Of Chinese Medicine

基　　金：福建中医药大学校管课题(XB2021152)。

摘　　要：溃疡性直肠炎是指在溃疡性结肠炎中炎症仅局限于直肠的一种疾病,病因不明,可能与免疫、感染等因素有关。病变主要累及直肠黏膜与黏膜下层,伴有糜烂和浅表溃疡,可向上扩展至结肠。临床上主要表现为腹泻、黏液脓血便、腹痛等。中医认为溃疡性直肠炎的基本病因在脾,脾为后天之本,气血生化之源。脾气不足可致脾之气机失调,升降失司,水湿停滞留于脾胃。脾虚则湿蕴;脾虚而致泻。因此无论此病处于活动期还是缓解期,健脾化湿应贯彻始终。在治疗上,以益气健脾、清热化湿、凉血化瘀、攻补兼施为要。八宝灌肠方具有抗菌、消炎、增强机体免疫系统功能的作用,能够防治肠道感染;同时具备消除肿痛、止血的作用,从而改善腹痛、腹泻、便血等症状,促进肉芽生长,加速溃口愈合。文章通过案例分享探讨溃疡性直肠炎病因病机及治法,为临床提供参考。Ulcerative Proctitis refers to a disease in ulcerative colitis in which inflammation is limited to the rectum,the cause is unknown,and may be related to immune,infection and other factors.Lesions mainly involve the rectal mucosa and submucosa,with erosions and superficial ulcers,which can extend upward to the colon.Clinically,the main manifestations are diarrhea,mucopurulent bloody stool,abdominal pain,etc..TCM believes that the basic cause of ulcerative proctitis lies in the spleen,which is the acquired foundation and the source of Qi(气)and blood biochemistry.Insufficient temper can cause spleen Qi imbalance,loss of rise and fall,moisture stagnation in the spleen and stomach,and spleen deficiency is wet,spleen deficiency and diarrhea.Therefore,whether the disease is active or in remission,spleen and moisture should be carried out throughout.In terms of treatment,it is important to invigorate Qi and strengthen the spleen,clear heat and moisture,cool blood and remove stasis and attack and replenish at the same time.The Babao enema prescription(八宝灌肠方)has the effect of antibacterial,anti-inflammatory,enhance the function of the body’s immune system,and can prevent and treat intestinal infections.At the same time,it has the effect of eliminating swelling pain and stopping bleeding,thereby improving the symptoms of abdominal pain,diarrhea,blood in the stool,etc.,promoting the growth of granulation and accelerating the healing of ulcers.This article discusses the etiology,pathogenesis and treatment of ulcerative proctitis through case sharing,and provides clinical reference.

关 键 词：溃疡性直肠炎 脾虚湿蕴证 八宝灌肠方 中药灌肠 

分 类 号：R256.3[医药卫生—中医内科学]