基于“中气不足,溲便为之变”论治小儿遗粪症  

Treatment of Children's Encopresis Based on“Deficiency of Middle-Qi Leading to Urine and Feces Change”

作　　者：邓媛 赵琼[1] 周鸿雲 刘茜玮 Deng Yuan;Zhao Qiong;Zhou Hongyun;Liu Qianwei(Clinical Medical College of Chengdu University of Traditional Chinese Medicine,Chengdu,610075,China;Affiliated Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu,610072,China;Clinical Medical College of Beijing University of Traditional Chinese Medicine,Beijing,100105,China)

机构地区：[1]成都中医药大学临床医学院,四川成都610075 [2]成都中医药大学附属医院,四川成都610072 [3]北京中医药大学临床医学院,北京100105

出　　处：《成都中医药大学学报》2024年第3期36-39,共4页Journal of Chengdu University of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81674026)。

摘　　要：小儿遗粪症归中医“遗矢”之列,以小儿反复且不能自控地排粪为主要表现。本病病因复杂,严重影响患儿身心健康,但其机制尚未阐明,且西医缺乏根治手段。中医辨治此病有独到优势,笔者结合导师临证经验,从“中气不足,溲便为之变”的理论出发,认为中气不足、积滞不化为本病关键病机,情志不畅、气机郁结是其重要病理因素。中气大虚,枢机不利,清阳不升,固摄无权,纳化失常,虚积相合,终致魄门失约,遗粪无度。故治当补益中气,少佐消导,方以补中益气汤加减化裁,尤应调畅情志,强化如厕训练,诸法合施,疗效颇佳。Children's encopresis,which belongs to the"YiShi"of traditional Chinese medicine(TCM),with children's repeated and uncontrollable defecation as the main manifestation.The etiology of this disease is complex,which seriously affects the physical and mental health of children,but its mechanism has not been clarified,and western medicine lacks the eradicating means.Traditional Chinese medicine has unique advantages in treating this disease.Based on the tutor's clinical experience and the theory of"deficiency of middle-Qi leading to urine and feces change",the author thinks that deficiency of middle-Qi and accumulation of diet become the key pathogenesis of this disease,emotional disorders caused by the Qi stagnation is an important pathological factor.Weakness of Qi in human body leads to unfavorable Qi activity,which leads to the inability of Qi to fix and absorb,abnormal absorption of Spleen and Stomach,mutual influence of Qi deficiency and food accumulation,and finally leads to anal dysfunction and uncontrollable fecal excretion.Therefore,the treatment is mainly based on invigorating Qi,supplemented by stagnation,and the prescription is based on Buzhong-yiqi decoction,which should be adjusted according to the syndrome,especially adjusting emotions and strengthening toilet training.Combining all methods,the effect is significant.

关 键 词：小儿遗粪症 中医辨治思路 中气不足 补中益气汤 临证经验 

分 类 号：R272[医药卫生—中医儿科学] R221[医药卫生—中医学]