基于疮疡理论辨治间质性膀胱炎/膀胱疼痛综合征  

Differentiation and Treatment of Interstitial Cystitis/Bladder Pain Syndrome Based on the Theory of Sores and Ulcers

作　　者：刘琼琼 庞然[2] 陈月莹 唐浚峰 曹凤钦 马棣元 LIU Qiongqiong;PANG Ran;CHEN Yueying;TANG Junfeng;CAO Fengqin;MA Diyuan(Beijing University of Chinese Medicine,Beijing,100029;Guang'anmen Hospital,China Academy of Chinese Medical Sciences)

机构地区：[1]北京中医药大学,北京市朝阳区100029 [2]中国中医科学院广安门医院

出　　处：《中医杂志》2024年第16期1712-1716,共5页Journal of Traditional Chinese Medicine

基　　金：国家重点研发计划(2018YFC2002203);首都卫生发展科研专项(首发2022-1-6011);北京市科技计划(Z161100000516156)。

摘　　要：认为间质性膀胱炎/膀胱疼痛综合征(IC/BPS)内镜下广泛出血、Hunner溃疡等表现以及其病情反复、迁延难愈的特点与中医学疮疡的特征相符,治疗上可参考疮疡的中医治疗思路。IC/BPS病机多表现为本虚标实,以脾肾亏虚为本,湿热、瘀血为标。治疗以托、补之法为本,兼用消法,以活血清热、通络止痛治其标。临证常用内托生肌散加减以益气活血,消肿托毒;同时结合具体症状配合四君子汤或缩泉丸健脾补肾以扶正,并根据瘀血、湿热等兼证针对性配伍三棱、莪术等活血化瘀,薏苡仁、泽泻等清热利湿。It is believed that the endoscopic manifestations of interstitial cystitis/bladder pain syndrome(IC/BPS)such as extensive bleeding and Hunner's ulcers as well as its recurrent and prolonged condition are in line with the characteristics of sores and ulcers in traditional Chinese medicine(TCM),and the treatment can be referred to TCM theory of sores and ulcers.The mechanism of IC/BPS is characterized by root deficiency and branch excess.The root cause is deficiency of the spleen and kidney qi,while the manifesting factors are dampness-heat and blood stasis.The treatment is based on the principles of promoting and supplementing,combining with resolving therapy,so that the symptoms could be relieved by promoting blood circulation and clearing heat,unblocking the collaterals and relieve pain.In clinical practice,modified Neituo Shengji Powder(内托生肌散)was commonly used to boost qi and invigorate blood,expel swollen sore and express toxin;combining with Sijunzi Decoction(四君子汤)or Suoquan Pill(缩泉丸)based on specific symptoms to strengthen the spleen and kidneys,thereby reinforcing healthy qi;according to concurrent symptoms like blood stasis,dampness heat,prescription with Sanleng(Cyperus rotundus),Ezhu(Curcuma aromatica Salisb)to invigorate blood and dissolve stasis,or Yiyiren(Coix lacryma-jobi),Zexie(Alisma plantagoaquatica)to clear heat and drain dampness.

关 键 词：间质性膀胱炎 膀胱疼痛综合征 疮疡 护场 脾肾亏虚 托法 补法 消法 

分 类 号：R277.5[医药卫生—中医学]