功能性胃肠病从“三焦胀”辨治探讨  

Exploring the Treatment of Functional Gastrointestinal Disorders from the Perspective of"Distension of the Triple Energizer"

作　　者：王建康 张徐 王杨帆 康琼巧 方俊剑 WANG Jiankang;ZHANG Xu;WANG Yangfan;KANG Qiongqiao;FANG Junjian(Jiangkou Street Community Health Service Center of Fenghua District in Ningbo,Ningbo,Zhejiang,China,315500;Xikou Hospital of Fenghua District in Ningbo,Ningbo,Zhejiang,China,315500)

机构地区：[1]宁波市奉化区江口街道社区卫生服务中心,浙江宁波315500 [2]宁波市奉化区溪口医院,浙江宁波315500

出　　处：《河南中医》2025年第2期205-210,共6页Henan Traditional Chinese Medicine

基　　金：国家中医药管理局全国名老中医药专家传承工作室建设项目{国中医药办人教函[2021]270号}。

摘　　要：功能性胃肠病的病理本质是以三焦腑功能受损,进而病及脾胃,导致脾胃功能失调,兼及心失藏神、肝失疏泄、肺失宣肃、肾(膀胱)失气化表现的多系统多方位的临床综合征。“三焦胀”是以三焦气机升降失司导致气机不畅或逆乱为核心、以脾胃功能失调为基本症状,兼及其他脏腑功能失调的脾胃综合征,与功能性胃肠病的各类症状具有高度类同性。三焦与脾胃的关系密切,三焦气机失调容易引发脾胃病症状,说明“三焦胀”与功能性胃肠病具有内在联系。其辨证应以三焦功能为核心,以调复三焦气化为根本,力求“三焦胀”与功能性胃肠病的病、证、理、法、方、药的有机统一,体现临床证治一元论、精准度、靶向性,提高功能性胃肠病的临床疗效。功能性胃肠病表现为“三焦胀”类同症状时常可分为以下4种证型辨治:腠理失通型、三焦郁热型、相火僭越型、水道壅滞型;常用方剂有小柴胡汤、柴胡桂枝汤、旋覆代赭汤、生姜泻心汤、栀子豉汤、乌梅丸等。The pathological essence of functional gastrointestinal disorders(FGIDs)is rooted in the dysfunction of the organs in the triple energizer,which further affects the spleen and stomach,leading to dysregulation of their functions.This condition often involves multisystem and multifaceted clinical syndromes,including the failure of the heart to house the mind,the liver to ensure smooth flow,the lung to regulate and descend,and the kidney(bladder)to perform qi transformation."Distension of the triple energizer"refers to a syndrome where the dysfunction of the triple energizer qi movement results in stagnation or reversal of qi,primarily manifesting as spleen-stomach dysfunction and often involving other organ dysfunctions.The symptoms of"distension of the triple energizer"closely resemble those of FGIDs.The close relationship between the triple energizer and spleen-stomach indicates that the dysfunction of distension of the triple energizer qi can easily trigger spleen-stomach symptoms,underscoring the intrinsic link between"distension of the triple energizer"and FGIDs.The differentiation of syndromes should focus on the function of the triple energizer,with an emphasis on restoring the triple energizer qi transformation as the fundamental approach.The goal is to achieve an organic unity of the disease,syndrome,theory,method,formula,and medicine in between"distension of the triple energizer"and FGIDs,reflecting the monistic view of clinical syndrome differentiation,precision,and targeting,ultimately improving the clinical efficacy in treating FGIDs.When FGIDs manifest with symptoms similar to"FGIDs,"they can often be classified into the following four syndrome types for differentiation and treatment:impaired interstitial connection syndrome,syndrome of stagnant heat in the triple energizer,hyperactivity of ministerial fire syndrome,and water pathway obstruction syndrome.Commonly used formulas include Minor Bupleurum Decoction,Bupleurum and Cinnamon Twig Decoction,Inula and Hematite Decoction,Fresh Ginger Heart-Draini

关 键 词：功能性胃肠病 《黄帝内经》 三焦胀 腠理失通证 三焦郁热证 相火僭越证 水道壅滞证 

分 类 号：R259[医药卫生—中西医结合]