名中医刘佃温从久病入络理论运用角药治疗慢性便秘经验  

Famous Chinese medicine Liu Dianwen’s experience in treating chronic constipation with angle medicine from the theory of prolonged illness invading the collaterals

作　　者：梁薇 刘佃温[2] 杨会举[2] LIANG Wei;LIU Dianwen;YANG Huiju(Henan University of Traditional Chinese Medicine,Zhengzhou 450046,China)

机构地区：[1]河南中医药大学,河南郑州450046 [2]河南中医药大学第三附属医院肛肠病医院,河南郑州450003

出　　处：《陕西中医》2024年第8期1118-1121,共4页Shaanxi Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(81774453);河南省科技攻关项目(222102310417);河南省中医药拔尖人才项目[豫卫中医函(2021)15号]。

摘　　要：刘佃温教授认为慢性便秘病程长,病久则气血运行不畅,病邪由经入络,故刘教授提出应以“久病入络”为理论治疗慢性便秘。以活血通络为基本治法,辨证辅以行滞化瘀、润肠通便等,并基于“久病入络”理论总结出五组角药。临证中常用桃仁-红花-赤芍活血化瘀、当归-生地-牛膝补虚润肠、柴胡-枳实-厚朴疏利气机、黄芪-白术-大黄补气健脾通便、地龙-虻虫-水蛭搜风入络,引经报使,并在此基础上注重患者日常养护,临床疗效显著。Professor Liu Dianwen posits that chronic constipation is characterized by a prolonged disease course,wherein the prolonged illness disrupts the smooth flow of qi and blood.This disruption leads to the pathogenic factors moving from the meridians to the collaterals.Therefore,professor Liu advocates for a treatment strategy for chronic constipation based on the principle of“prolonged illness invading the collaterals”.The fundamental treatment approach emphasizes activating blood circulation and unblocking the collaterals,with differential treatment strategies that include promoting movement to alleviate stagnation,transforming stasis,moistening the intestines,and facilitating bowel movements.Based on the“prolonged illness invading the collaterals”theory,five groups of angle medicines have been summarized.Commonly used in clinical practice are combinations such as Peach kernel-Carthamus tinctorius-Radix paeoniae rubra to activate blood circulation and remove stasis,Angelica sinensis-Raw rehmannia glutinosa-Achyranthes bidentata to nourish deficiency and moisten the intestines,Bupleurum-Fructus aurantii immaturus-Magnolia officinalis to regulate the qi mechanism,Astragalus membranaceus-Atractylodes macrocephala-Rheum palmatum to tonify qi,strengthen the spleen,and facilitate bowel movements,and Earthworm-Tabanus-Hirudo to expel wind and target the collaterals,drawing the meridians to exert their functions.Additionally,emphasis is placed on the patients’daily maintenance,with the clinical efficacy being significant.

关 键 词：慢性便秘 久病入络 从瘀论治 角药 虫类药 活血通络 

分 类 号：R574[医药卫生—消化系统]