韩宝教授基于脉络学说“孙络-微血管”理论治疗痔病的诊疗思路  

Professor Han Bao′s Experience in the Diagnosis and Treatment of Hemorrhoidal Disease Based on the Tertiary Collateral-Microvessel Theory

作　　者：叶宇飞[1] 曹科[1] 丁亚鹏 徐慧岩[1] YE Yu-fei;CAO Ke;DING Ya-peng;XU Hui-yan(Department of Proctology in Traditional Chinese Medicine,the Sixth Medical Center of PLA General Hospital,Beijing 100853)

机构地区：[1]解放军总医院第六医学中心中医医学部肛肠科,北京100853

出　　处：《世界中西医结合杂志》2024年第12期2527-2529,2534,共4页World Journal of Integrated Traditional and Western Medicine

基　　金：北京市中医药薪火传承“3+3”工程立项韩宝基层老中医传承工作室(2021-JC-1);北京市中医管理局第六批北京市级中医药专家学术经验继承工作项目(京中医科字[2021]169号);第七批全国老中医药专家学术经验继承工作项目(国中医药办人教发[2021]17号)。

摘　　要：目前针对痔病(Haemorrhoidal disease,HD)的中医治疗一直围绕在实则清热解毒,虚则补中益气上,治疗效果因人而异,大多患者仍免不了手术之痛,复发之苦。近些年脉络学说在心脑肾等脏器血管功能异常引起的内科疾病的诊疗中每获良效,韩宝教授认为HD虽属中医外科范畴,但肠腑末端微小脉络亦为孙络,肛垫黏膜经脉血管亦属微血管,且供五脏生成之气血与供六腑生成之气血同源自营卫之气,同源多歧,在病生理研究上应有共通之处,文中试用脉络学说中的孙络-微血管理论理解HD的发生发展机制,探索HD在整体观念下内外同治的治疗思路,也为脉络学说开辟更广阔的应用空间。The traditional Chinese medicine(TCM)treatment of haemorrhoidal disease(HD)follows the principles of clearing heat and removing toxin in the case of excess and tonifying middle energizer and replenishing qi in the case of deficiency,which achieve different effects in different patients.Moreover,most patients still suffer from the pain of operation and recurrence.In recent years,the TCM diagnosis and treatment of the diseases caused by abnormal vascular functions in organs such as the heart,brain,and kidney based on the vessel-collateral theory has achieved satisfactory results.Profes⁃sor Han Bao believes that although HD is a surgical disease in TCM,the microvessels at the end of the intestine and fu-organs are tertiary collaterals,and the mucosal vessels of anal pad are microvessels.The qi and blood generated by the five zang-organs and six fu-organs share the same origin,i.e.,nutrient-defense qi,and thus should have common points in the pathophysiology.This paper explains the occurrence and development mechanisms of HD from the tertiary collateral-microvessel theory,a part of the vessel-collateral theory,and explores the idea of internal and external treatment of HD from a holistic view,expanding the application of the vessel-collateral theory.

关 键 词：韩宝 痔病 孙络-微血管 营卫 脉络学说 名医经验 

分 类 号：R657.18[医药卫生—外科学]