从伏邪致病辨治腹泻型肠易激综合征  

Differentiating and Treating Diarrhea-Predominant Irritable Bowel Syndrome from the Pathogenesis of Latent Pathogen Causing Diseases

作　　者：李含梅 康亮 陈昫[2] 樊冬梅[2] LI Han-Mei;KANG Liang;CHEN Xu;FAN Dong-Mei(The First Clinical Medical School,Guangzhou University of Chinese Medicine,Guangzhou 510006 Guangdong,China;The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China)

机构地区：[1]广州中医药大学第一临床医学院,广东广州510006 [2]广州中医药大学第一附属医院,广东广州510405

出　　处：《广州中医药大学学报》2024年第2期491-495,共5页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(编号:81904145)。

摘　　要：腹泻型肠易激综合征(diarrhea-predominant irritable bowel syndrome,IBS-D)是临床常见的功能性胃肠病,其易受激惹、反复发作的临床特点及中医病机演变过程与伏邪致病有诸多相似之处。基于IBS-D “湿邪内伏”“气郁内伏”及“瘀血内伏”的中医病机演变特点,可通过区分患者大便性状、腹部切诊和舌下络脉表现以进行IBS-D“湿、滞、瘀”伏邪病机的分类和病情的分级,并提出了疏利内伏之湿邪、条畅内伏之郁气、疏通内伏之瘀血的治则。基于伏邪致病辨治IBS-D,为完善中医治疗IBS-D的理论和拓展伏邪学说的临床应用提供了思路。Diarrhea-predominant irritable bowel syndrome(IBS-D)is a common functional gastrointestinal disease.The irritable and recurrent clinical characteristics of IBS-D and its evolution process of traditional Chinese medicine(TCM)pathogenesis accord with the pathogenesis of latent pathogen causing diseases.Based on the analysis of the evolution process of IBS-D TCM pathogenesis from insidious latent pathogenic dampness and insidious latent qi depression to insidious latent blood stasis,the pathogenesis classification of insidious latent dampness,qi stagnation and blood stasis of IBS-D and its grading of illness were performed through distinguishing the patients’stool characters,abdominal palpation,and the inspection of sublingual veins.Moreover,the therapeutic principles of soothing and dredging the insidious latent pathogenic dampness,soothing the insidious latent qi depression and removing the insidious latent blood stasis were proposed.Differentiating and treating IBS-D from the pathogenesis of latent pathogen causing diseases will provide the idea of perfecting the theory of Chinese medicine in treating IBS-D and expanding the clinical application of the theory of latent pathogen.

关 键 词：肠易激综合征 伏邪 湿 滞 瘀 大便性状 腹部切诊 舌下络脉 

分 类 号：R256.3[医药卫生—中医内科学]