许二平从“肝脾”论治难治性溃疡性结肠炎  

Professor Xu Erping′s Experience in Treatment of Refractory Ulcerative Colitis from Perspective of Liver and Spleen

作　　者：王佳 许二平[1,2] 李伟峰[1] WANG Jia;XU Erping;LI Weifeng(Henan University of Chinese Medicine,Zhengzhou Henan China 450046;Henan Provincial Hospital of Chinese Medicine/The Second Affiliated Hospital to Henan University of Chinese Medicine,Zhengzhou Henan China 450002)

机构地区：[1]河南中医药大学,河南郑州450046 [2]河南中医药大学第二附属医院/河南省中医院,河南郑州450002

出　　处：《中医学报》2024年第6期1255-1259,共5页Acta Chinese Medicine

基　　金：国家中医药管理局第七批全国名老中医药专家学术经验继承工作项目{国中医药人教函[2022]76号};河南省优秀青年科学基金项目(202300410249);河南省科技攻关项目(222102310233)。

摘　　要：难治性溃疡性结肠炎病机皆因脾阳虚衰,运化失司,病久脾胃运化失常则气血化生不足,加之气机不畅,气血壅滞,肠络受损,究其根本主要在于肝气郁结,脾虚湿盛。脾虚为本,湿邪为标,肝郁为关键因素。治疗应疏肝与健脾并举,燥湿与行气并用,兼顾情志调和,灵活用药,因人制宜。临证常以香砂六君子汤为基础加减化裁,多用桂枝、黄芪、补骨脂、肉豆蔻以温阳,多用三七、蒲黄、白及、荆芥炭以活血止血,并嘱患者用灶中黄土煎汤,取其上清液熬药以助补脾,更好地发挥药物补脾止泻之功效。The pathogenesis of refractory ulcerative colitis is the Spleen Yang deficiency induced transporting and transmitting dysfunction.The abnormal function of the Spleen and Stomach for a long time leads to insufficient producing of Qi and blood,coupled with poor Qi movement,stagnation of Qi and blood,the damage to the intestinal network would take place.The fundamental case in the stagnation of Liver Qi and the deficiency of Spleen induced Dampness.Spleen deficiency is the foundation,Dampness is the outcome and Liver Qi depression is the key factor.The treatment should be carried out to soothe the Liver Qi and strengthen the Spleen at the same time,to relieve Dampness and activating Qi movement at the same time,considering the harmony of emotions,with the flexible use of drugs based on the conditions of the patients.Modified Xiangsha Liujunzi Decoction is commonly used in clinic.Guizhi(Ramulus Cinnamomi),Huangqi(Astragali Radix),Buguzhi(Psoraleae Fructus)and Doucou(Amomi Fructus Rotundus)are usually used to warm Yang,and Sanqi(Notogiseng Radix et Rhizoma),Puhuang(Typhae Pollen),Baiji(Bletillae Rhizoma)and Jingjietan(Herba Schizonpatae Carbonisatum)are usually used to invigorate blood and stop bleeding.Besides,instruct the patient to make decoction of loess in the stove and take its supernatant to boil medicine to help replenish the Spleen,to better play the effect of medicine to replenish the Spleen and stop diarrhea.

关 键 词：难治性溃疡性结肠炎 从“肝脾”论治 温阳药 血药 许二平 

分 类 号：R249.27[医药卫生—中医临床基础]