常忠生主任医师辨治慢性便秘临床经验  

Chief physician CHANG Zhongsheng’s experience of in dialectical treating chronic constipation

作　　者：朱煜璋 常忠生(指导) ZHU Yuzhang;CHANG Zhongsheng(Anorectal Department,Pudong New Area Guangming Hospital of Traditional Chinese Medicine,Shanghai,201399,China)

机构地区：[1]上海市浦东新区光明中医医院肛肠科,上海201399

出　　处：《甘肃中医药大学学报》2024年第6期17-21,共5页Journal of Gansu University of Chinese Medicine

基　　金：上海市浦东新区系统名中医工作室建设项目(PWR-zm2020-11);上海市浦东新区“国家中医药发展综合改革试验区”建设项目(PDZY-2021-1012)。

摘　　要：常忠生主任医师认为,慢性便秘多由肺脾气虚、阴液不足、肾阳亏虚,日久致瘀,或又因感受外邪、七情不和、劳倦失宜、饮食不节等,致使大肠传导失司,糟粕秘结不得下。治疗时应“从虚治之”“以补益气阴为通、兼温补肾阳”,不可滥用诸如大黄、番泻叶、芦荟等攻下类中药。久病常法不得效者,可考虑“从瘀论治”。此外,常主任强调应重视情志及日常生活调摄,并需坚持服用中药。附典型病案2则以验证。Chief physician CHANG Zhongsheng posits that chronic constipation typically arises from deficiencies in lung and spleen qi,a lack of yin fluids,and a deficiency of kidney yang,leading to stasis over time.Alternatively,it may stem from external pathogenic influences,emotional imbalance,excessive fatigue,or inappropriate die-tary habits,which cause impairment of the large intestine's function in transmitting waste and causing fecal retention.Treatment should be based on“treating deficiency”and“using tonifying and nourishing qi and yin to facilitate bowel movements and warm the kidney Yang,”and avoiding using strong laxatives such as Rheum palmatum L.,Folium Sennae,and Aloe arborescens Mill..For individuals who have endured chronic constipation over an extended period and have not found relief through traditional treatments,“treating blood stasis”could be a viable option to consider.Furthermore,Chief physician CHANG emphasizes the importance of addressing emotional factors alongside daily life adjustments;he advocates for continued use of Chinese medicine as part of the treatment regimen.Two typical medical records are attached for verification.

关 键 词：慢性便秘 从虚治之 助阳通便 从瘀论治 临床经验 常忠生 

分 类 号：R256.35[医药卫生—中医内科学] R249[医药卫生—中医学]