基于“木郁达之”理论探析排便障碍型便秘的诊治思路  

Diagnosis and treatment of constipation due to defecation disorders based on the theory of"ventilating the wood when it being stagnated"

作　　者：陈亚光[1] 邸莎 王处渊 CHEN Yaguang;DI Sha;WANG Chuyuan(Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China)

机构地区：[1]中国中医科学院广安门医院,北京100053

出　　处：《吉林中医药》2024年第10期1138-1141,共4页Jilin Journal of Chinese Medicine

基　　金：国家自然科学基金项目(81774296);中国中医科学院广安门医院临床医学研究中心建设专项资助项目(2022LYJSZX16)。

摘　　要：“木郁达之”理论首见于《黄帝内经》,通过追溯其理论源流发现:“木郁”是对肝脏生理功能失常的高度概括,即肝失疏泄。“达之”是一种治疗原则,目的在于使肝气条达、舒畅。排便障碍型便秘是临床常见病,肝失疏泄作为基本病机贯穿疾病始终,并常伴见脾虚湿阻、肺失宣降、肾阳不足等。临床辨治上以“达之”为治疗原则,针对肝脏自身病变灵活应用养血柔肝、疏肝理气、清肝泻火、温补肝阳,并视患者情况不同予以升阳除湿、肃降肺气、温补肾阳等。The theory of"ventilating the wood when it being stagnated"was first introduced in the Huangdi Neijing.Through tracing the origin of the theory,it is found that"wood stagnation"is a high generalization of the physiological dysfunction of the liver,that is,the liver failing in its functions of conveyance and dispersion,while"ventilating a stagnated liver"is a therapeutic principle aimed at smoothing the circulation of liver qi.Constipation caused by defecation disorders is a common disease in clinical practice,in which a failure of the liver in conveyance and dispersion constitutes its basic pathogenesis and runs through its entire course.At the same time,the disease is often accompanied by damp obstruction due to spleen deficiency,lung qi failing in dispersing and descending,and kidney yang deficiency.In its clinical syndrome differentiation and treatment,"ventilating the stagnated liver"is taken as a therapeutic principle,under which constipation due to defecation disorders is often treated with the methods of nourishing blood and softening the liver,dispersing the liver and regulating qi,clearing liver-fire,and warmly invigorating liver yang,etc.Depending on patients'conditions,methods such as ascending yang and eliminating dampness,purifying and descending lung qi,and warmly invigorating kidney yang can also be applied.

关 键 词：木郁达之 肝失疏泄 养血柔肝 疏肝理气 清肝泻火 温补肝阳 

分 类 号：R256.3[医药卫生—中医内科学]