基于“诸痿喘呕,皆属于上”探析从肺辨治胃轻瘫  

Discussion on syndrome differentiation and treatment of gastroparesis based on the theory of"atrophy,dyspnea and vomiting are ascribed to the upper part"based on the lung

作　　者：张天华 魏星 岳增辉[1] 彭艳[1] ZHANG Tianhua;WEI Xing;YUE Zenghui;PENG Yan(College of Acupuncture-Moxibustion-Tuina and Rehabilitation,Hunan University of Chinese Medicine,Changsha 410208,China)

机构地区：[1]湖南中医药大学针灸推拿与康复学院,长沙410208

出　　处：《北京中医药大学学报》2024年第4期485-489,共5页Journal of Beijing University of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(No.81774431);湖南省教育厅科学研究项目(No.22A0275);湖南省自然科学基金项目(No.2022JJ40310);长沙市自然科学基金项目(No.kq2202263);湖南中医药大学校级重点项目(No.2022XJZKA001)。

摘　　要：胃轻瘫是以胃排空延迟为特征的胃部疾病,“呕”为其主要临床表现,“痿”为胃之功能废而无用。本文基于《素问·至真要大论篇》“诸痿喘呕,皆属于上”理论,从肺的功能探析胃轻瘫的发病机制与治疗思路。肺气耗伤则气血运行不畅,胃部无以荣养,致胃受纳功能失司;忧(悲)过极、肺气郁滞则肺宣降失常,致胃通降功能不利;肺失肃降则肠胃失于虚实交替运行,致胃运化功能失常。故而提出益肺补气以和胃、消忧畅肺以调胃、通腑理肺以降胃的治疗思路,从而改善胃受纳腐熟、通降运化的功能,促进胃动力的恢复,以期为临床上从肺论治胃动力障碍性疾病提供现代医学依据,拓宽治疗思路。Gastroparesis is a gastric disease characterized by delayed gastric emptying."Vomiting"is the main clinical manifestation of this disease,while"atrophy"indicates dysfunction of the stomach.Based on the theory of"atrophy,dyspnea and vomiting are ascribed to the upper part",originating from the Chapter of"Zhi Zhen Yao Da Lun"from the Suwen(Basic Questions)section this paper explored the pathogenesis and treatment idea of gastroparesis from the function of the lung.It is put forward that failure of lung qi in dispersion,so the lung qi cannot maintain the circulation of harmonizing qi and blood,leading to malnutrition of stomach and loss of stomach receiving food and drink function.Melancholy impairing lung,so lung cannot govern diffusion,leading to stomach governing the disfunction of dredging and descending.Impaired depurative descending of lung qi,so the large intestine and stomach are lost in the alternating operation of deficiency and excess,leading to stomach governing the disfunction of transportation and transformation.Therefore,the treatment approach is proposed to improve the stomach's function to receive food and drink,transport and transform and promote the recovery of gastric motility by replenishing and restoring lung qi,regulating emotions and catharsis and smoothing lung.Analyzing the effect of function of the lung on gastric motility is of great value for expanding the application of traditional Chinese medicine in gastrointestinal motility disorders,and digging new connotations of classic theories in modern clinical practice.

关 键 词：黄帝内经 肺 胃轻瘫 胃动力 

分 类 号：R259[医药卫生—中西医结合]