基于宣补通降法论治便秘型肠易激综合征  

Treating constipation-type irritable bowel syndrome based on the therapy of Xuanbu Tongjiang

作　　者：鞠苏岚 张怡 孙倩倩 胡晨 董筠[1] JU Sulan

机构地区：[1]南京中医药大学附属医院,江苏南京210029

出　　处：《中医临床研究》2024年第10期138-142,共5页Clinical Journal Of Chinese Medicine

摘　　要：肠易激综合征是一种与胃肠功能改变相关的功能性疾病,其作为消化科常见疾病之一,发病机制目前尚未被阐明,临床上主要表现为慢性或复发性腹胀、腹痛、排便习惯改变及大便性状的异常,可分为腹泻型、便秘型、混合型和未定型。便秘型肠易激综合征作为肠易激综合征的亚型之一,在全球的发病率为22%。由于现代生活的快节奏化,目前,该病发病率呈现出逐年上升趋势。便秘型肠易激综合征作为现代的常见疾病,往往易因情志异常被诱发或加重。中医学多将其归属于“便秘”“腹痛”等范畴,其病位在大肠。西医治疗以对症为主,疗效欠佳,且疾病往往易反复发作,而中医强调辨证施治,讲究个体化治疗,对该病的治疗有独特优势。对此,文章依据肺与大肠相表里等相关脏腑理论,认为便秘型肠易激综合征发病核心为肠腑气壅,并提出相应的治疗大法——宣补通降法,从宣肺揭盖、培土生金、清肺通腑三方面具体论治便秘型肠易激综合征,从而使得肠腑气机条畅,便秘得消。并结合典型医案分析宣补通降法治疗该病的成功经验,为临床治疗便秘型肠易激综合征提供参考。Irritable bowel syndrome is a functional disease related to the changes of gastrointestinal function.As one of the common diseases in digestive department,the pathogenesis of irritable bowel syndrome has not been elucidated.The main clinical manifestations are chronic or recurrent abdominal distension,abdominal pain,changes of defecation habits and abnormal stool characteristics,which can be divided into diarrhea type,constipation type,mixed type and unstereotyped type.Constipation-type irritable bowel syndrome,a subtype of irritable bowel syndrome,has a global incidence of 22%.Due to the fast rhythm of modern life,the incidence of the disease is increasing year by year.As a common disease in modern times,constipation-type irritable bowel syndrome is often aggravated by emotional abnormality.In traditional Chinese medicine,it mostly belongs to the categories of constipation and abdominal pain,and the disease is located in the large intestine.Western medicine treatment is mainly symptomatic,the efficacy is not good.The disease is often prone to repeated attacks,while TCM emphasizes differential treatment and pays attention to individualized treatment,which has unique advantages in the treatment of this disease.In this regard,this paper believes that the core of the onset of irritable bowel syndrome of constipation is intestinal Qi(气)according to the theory related organs such as the relationshif between the lungs and the large intestine.And proposes the therapy of Xuanbu Tongjiang(宣补通降法),which specifically treats irritable bowel syndrome of constipation from the three aspects,dispersing the lungs and removing the lids,reinforcing earth to generate metal,and clearing the lungs and dredging the fu-organs(腑).Combined with the analysis of famous medical cases,the successful experience of the therapy of Xuanbu Tongjiang in the treatment of the disease is given to provide new ideas for the clinical treatment of comstipation-type irritable bowel syndrome.

关 键 词：便秘型肠易激综合征 宣补通降法 肺与大肠相表里 

分 类 号：R256.3[医药卫生—中医内科学]