黔中黄氏儿科流派“运脾斡旋法”辨治儿童功能性消化不良经验  

Treatment experience of functional dyspepsia in children by the"Spleen regulation and mediation method"of the Huang's Pediatric School in central Guizhou Province

作　　者：彭玉 吴敏 刘启艳 陈竹 孙海鹏 杨见辉 冷丽 庞平 叶倩 PENG Yu;WU Min;LIU Qiyan;CHEN Zhu;SUN Haipeng;YANG Jianhui;LENG Li;PANG Ping;YE Qian(The Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine,Guiyang 550003,China;Graduate School of Guizhou University of Traditional Chinese Medicine,Guiyang 550001,China)

机构地区：[1]贵州中医药大学第二附属医院儿科,贵阳550003 [2]贵州中医药大学,贵阳550001

出　　处：《中国中西医结合儿科学》2024年第6期468-472,共5页Chinese Pediatrics of Integrated Traditional and Western Medicine

基　　金：彭玉全国名老中医药专家传承工作室项目(国中医药人教函〔2022〕75号)。

摘　　要：功能性消化不良(FD)是儿童常见消化系统疾病,临床以餐后饱胀、早饱、上腹部疼痛或上腹部烧灼感为主症,可伴嗳气反酸、恶心呕吐、食少腹胀,症状多样。FD易反复发作,病程较长,中医根据其主症特点,归属于“腹痛”“腹胀”“痞满”“呕吐”等病范围辨治,其病因多为饮食或病后失调所致,病机为脾胃升降气机功能失调。黔中黄氏儿科流派认为小儿FD无论虚实,“脾失健运,斡旋失司”是其病机关键,亦是产生“痞满胀痛”诸症的核心病机,临证通过辨识患儿症状轻重、病程长短及山根、肉轮之形色,判断FD“痞满胀痛”证候特点与寒热虚实,创立“运脾斡旋法”,运用“运脾消痞散”辨治,以期快速恢复FD患儿“脾运”之功能及“斡旋四脏”气机之态,为中医治疗儿童FD提供临证参考。Functional dyspepsia(FD)is a common digestive disorder among children.Clinically,it is primarily characterized by postprandial fullness,early satiety,upper abdominal pain,or a burning sensation in the upper abdomen.It may also be accompanied by symptoms such as belching,acid regurgitation,nausea,vomiting,poor appetite,and abdominal distension,presenting a wide range of manifestations.FD is prone to recurrence and has a relatively prolonged course.According to its main symptoms,it is categorized into conditions such as"abdominal pain,""abdominal distension,""epigastric fullness,"and"vomiting"for syndrome differentiation and treatment in traditional Chinese medicine(TCM).The etiology of FD is often attributed to improper diet or post-illness disorders,with the pathogenesis being dysfunction in the ascending and descending mechanisms of the spleen and stomach qi.In Huang's Pediatric School of central Guizhou Province,it is believed that whether it is deficiency or excess,"the failure of the spleen to transport and regulate"is the key to the pathogenesis of pediatric FD,and it is also the core pathogenesis of the symptoms such as"epigastric fullness,distension,and pain."In clinical practice,the severity of symptoms,duration of the disease,and characteristics of the nasal root and eyelids are assessed to determine the nature of the syndrome,including cold,heat,deficiency,and excess.Thus,the"Spleen regulation and mediation method"is established,and the"Spleen-regulating and Fullness-relieving powder"is used for syndrome-differentiated treatment,aiming to rapidly restore the"spleen-transporting"function in children with FD and achieve the state of the spleen"regulating the qi of the four viscera,"which provides a clinical reference for TCM treatment of pediatric FD.

关 键 词：功能性消化不良 贵州 黄氏儿科流派 运脾斡旋 运脾消痞散 儿童 

分 类 号：R725.7[医药卫生—儿科]