葛琳仪运用清法分期论治溃疡性结肠炎经验  

GE Linyi's Experience in the Treatment of Ulcerative Colitis by Stages with the Method of Clearing

作　　者：袁晓[1] 姜宁[1] 孙菊 李中洲 黄宣[1] 葛琳仪(指导)[1] YUAN Xiao;JIANG Ning;SUN Jyu;LI Zhongzhou;HUANG Xuan(The First Affiliated Hospital of Zhejiang Chinese Medical University,Hangzhou,310006)

机构地区：[1]浙江中医药大学附属第一医院,浙江杭州310006

出　　处：《中医杂志》2024年第10期996-1000,共5页Journal of Traditional Chinese Medicine

基　　金：第三届国医大师传承工作室建设项目(国中医药办人教函[2018]119号);浙江省中医药科技计划(2022ZA072);浙江省中青年临床名中医项目(浙中医药[2021]22号)。

摘　　要：总结葛琳仪教授运用清法分期论治溃疡性结肠炎的经验。认为溃疡性结肠炎核心病机为肠腑湿热,提出治疗以清法为基础,立清化、清疏、清润、清养四法。溃疡性结肠炎活动期病机为肠腑湿热、气血壅滞、瘀毒蕴积,治以清化兼清疏为法,清化法常用白头翁汤配伍黄芩、马齿苋、蒲公英为基本方以清化湿热、凉血解毒止痢;同时配合清疏法,常用柴胡、醋香附、木香、枳壳、槟榔等理气之品,当归、侧柏叶、地榆炭等调血之品。缓解期病机为正气亏虚且肠腑湿热瘀毒余邪未尽,治以清养、清润为法,清润法主要针对阴津受损者,自拟清润益肠汤;清养法主要针对脾胃虚弱者,自拟清养健脾汤。This paper summarized the clinical experience of Professor GE Linyi in treating ulcerative colitis(UC)by stages with the method of clearing.Professor GE believes that the core pathogenesis of UC is dampness and heat in the intestines,and by taking the method of clearing as the basis,he proposed four methods for treatment of UC including clearing and transforming,clearing and dispersing,clearing and moisterning,clearing and nourishing.The pathogenesis of UC in its active stage is dampness and heat in the intestines,congestion and stagnation of qi and blood,and accumulation of stasis toxins,for which the treatment method is to clear and transform,accompanied by clearing and dispersing method.In terms of the clearing and transforming method,Bai Tou Weng Decoction(白头翁汤)combined with Haungqin(Radix Scutellariae),Machixian(Herba Portulacae)and Pugongying(Herba Taraxaci)is taken as the basic prescription to clear and transform dampness and heat,cool blood,resolve toxins and stop dysen-tery.For the clearing and dispersing method,medicinals to rectify qi such as Chaihu(Radix Bupleuri),Cuxiangfu(Vingar Rhizoma Cyperi),Muxiang(Radix Aucklandiae),Zhiqiao(Fructus Aurantii),and Binlang(Semen Arecae),as well as those to regulate blood such as Danggui(Radix Angelicae Sinensis),Cebaiye(Cacumen Platycladi)and Diyutan(Radix Sanguisorbae Carbonisatus)are recommended.The pathogenesis of the remission stage is healthy qi depletion and lingering pathogen of dampness and heat stasis toxin in the intestines,for which the method of clearing and nourishing,clearing and moistening can be used;the latter is mainly for people with yin fluids injury,and selfmade Qingrun Yichang Decoction(清润益肠汤)is recommended,while the former is for those with spleen and stomach weakness,and self-made Qingyang Jianpi Decoction(清养健脾汤)can be used.

关 键 词：溃疡性结肠炎 清法 分期论治 名医经验 葛琳仪 

分 类 号：R259[医药卫生—中西医结合] R249[医药卫生—中医内科学]