以痈论治溃疡性结肠炎理论阐释及临床思路探析  

Theoretical explanation and clinical analysis of treating ulcerative colitis from the perspective of carbuncle

作　　者：张斯瑶[1,2] 于永铎 柳越冬[2] 陈萌[2] 齐颖超[1] ZHANG Siyao;YU Yongduo;LIU Yuedong;CHEN Meng;QI Yingchao(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,China;The Third Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110003,China;The Second Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,China)

机构地区：[1]辽宁中医药大学,沈阳110847 [2]辽宁中医药大学附属第三医院,沈阳110003 [3]辽宁中医药大学附属第二医院,沈阳110032

出　　处：《吉林中医药》2024年第4期387-391,共5页Jilin Journal of Chinese Medicine

基　　金：辽宁省“兴辽英才计划”项目(XLYC2002002);辽宁省重点研发计划项目(2020JH2/10300062);2020年度国家自然科学基金资助项目(82074449)。

摘　　要：于永铎认为,痈为火毒生,下利脓血为热毒本质,提出“病由毒起,热毒伤肠”为溃疡性结肠炎病机关键,“邪踞火毒”“湿热毒邪”“正虚伏毒”为溃疡性结肠炎的核心病机演变规律,体现热毒伤肠络,毒邪由实致虚,虚实夹杂的病邪转变过程。结合从肠黏膜屏障损伤、免疫功能紊乱、细胞自噬、凋亡、焦亡的病变特点及交叉转化的因果联系,提出以痈论治溃疡性结肠炎的核心治法,采用清热解毒、凉血消痈,清热利湿、解毒消痈,健脾益气、托毒消痈等辨治策略,并结合临床验案进行分析,以期为溃疡性结肠炎的治疗提供参考。Yu Yongduo believes that carbuncle is caused by fire-toxicity,and heat-toxicity is characterized by diarrhea and pyemia,proposing that"the disease starting from toxicity,and heat-toxicity entering the intestine"is the key pathogenesis of ulcerative colitis,and"fire toxicity","dampness heat",and"hidden toxicity due to deficient vital qi"are the core pathogenesis evolution laws of the disease,refl ecting the pathogen transformation process that heattoxicity harms the intestine,transforms from excess to deficiency,and deficiency intermingles with excess.Based on the pathological characteristics of intestinal mucosal barrier injury,immune dysfunction,autophagy,apoptosis,and pyroptosis,as well as the causal relationship of cross-transformation,this study aims to explore the syndrome differentiation values in the treatment of UC from the perspective of carbuncle.In addition,it is proposed that some treatment strategies be adopted,including clearing heat and detoxifying,cooling blood to eliminate carbuncles,clearing heat and promoting diuresis,detoxifying and resolving carbuncles,strengthening the spleen and benefiting qi,and expelling toxicity to eliminate carbuncles.These strategies are analyzed in combination with clinical cases,with a view to providing a reference for the clinical treatment of UC.

关 键 词：久痢 溃疡性结肠炎 以痈论治 

分 类 号：R259[医药卫生—中西医结合]