基于“气一元论”探析尹氏中医辨治肝硬化腹水  

Yin′s Traditional Chinese Medicine Treatment of Ascites in Liver Cirrhosis Based on"Qi Monism"

作　　者：尹在田 尹亚东[2] 刘书红 YIN Zaitian;YIN Yadong;LIU Shuhong(Henan University of Chinese Medicine,Zhengzhou Henan China 450046;The First Affiliated Hospital to Henan University of Chinese Medicine,Zhengzhou Henan China 450000;The People′s Hospital of Wuyang County,Wuyang Henan China 462400)

机构地区：[1]河南中医药大学,河南郑州450046 [2]河南中医药大学第一附属医院,河南郑州450000 [3]舞阳县人民医院,河南舞阳462400

出　　处：《中医学报》2024年第11期2356-2360,共5页Acta Chinese Medicine

基　　金：河南省级首批优质中医学术流派“尹氏理气解郁学术流派”项目{豫卫中医函〔2022〕63号};河南省级第五批中医非物质文化遗产代表性项目{豫政〔2021〕21号};河南省级科技成果《“理气解郁疗法”体系的构建及临床应用》项目(2024HA010008)。

摘　　要：肝硬化腹水是肝硬化失代偿期最常见的并发症,也是肝硬化病程进展中的重要标志。腹水的出现提示肝硬化预后不良,故肝硬化腹水的治疗仍是临床的难点。尹氏中医立足于传统哲学“气一元论”,经丰富临床实践总结,认为肝硬化腹水的发病是以“本体虚衰,责于肝,发之为本”为先,继之“气机失常,传于脾,郁之为患”,因“气化失常,舍于肾,继之为变”,脏腑相关,“气”“郁”相因,交杂为患。尹氏中医辨治肝硬化腹水,以理气解郁法为治则,以“固本体虚衰以和三脏、疏肝脾气机以达六郁、温肾阳化气以复通利”为治疗大法,临床运用效果显著。Ascites in cirrhosis is the most common complication of decompensated cirrhosis,and it is also an important marker in the natural history of cirrhosis.The presence of ascites indicates a poor prognosis of cirrhosis,so the treatment of ascites in cirrhosis is still a difficult clinical problem.Based on the traditional philosophy of"Qi monism"and by summarizing rich clinical practice,Yin′s TCM doctors believe that the onset of ascites in liver cirrhosis is based on"Liver induced deficiency displaying in Liver",followed by"Qi disorder affecting Spleen and inducing depression problem"as well as"Qi transforming dysfunction affecting Kidney and inducing lesion.Zang and Fu is related,and"Qi"and"depression"are mutual cause and effect.All of the them mix with each other and lead to disease.Yin′s traditional Chinese medicine doctors distinguishes and treats ascites with cirrhosis of the liver,with the principle of regulating Qi and relieving depression,and with the treatment methods as follows:consolidating the deficiency of the body to reconcile the three Zang,namely,Liver,Spleen and Kidney,soothing the Liver and Spleen Qi activity to solve the six depressions as well as warming Kidney Yang to restore the normal Qi movement of the body".The clinical application effect is remarkable.

关 键 词：肝硬化腹水 尹氏中医 “气一元论” 理气解郁法 

分 类 号：R256.42[医药卫生—中医内科学]