从气血水论治溃疡性结肠炎的理论探索及应用  

Theoretical Exploration and Application of Treating Ulcerative Colitis from Qi,Blood and Water

作　　者：黄艳霞 江健俐 潘爱珍[1] HUANG Yanxia;JIANG Jianli;PAN Aizhen(Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University,Guangdong Guangzhou 510120,China)

机构地区：[1]中山大学孙逸仙纪念医院,广东广州510120

出　　处：《中医药临床杂志》2025年第1期23-27,共5页Clinical Journal of Traditional Chinese Medicine

基　　金：广东省基础与应用基础研究基金项目(2019A1515111105);广东省自然科学基金面上项目(2021A1515010239)。

摘　　要：溃疡性结肠炎(ulcerative colitis,UC)与中医学中“泄泻”“便血”等疾病关系密切,作为消化系统中常见的疑难慢性疾病,目前尚无疗效确切的治疗手段,因其具有反复发作、缠绵难愈的特点,已成为严重影响人类健康的常见病。现代医学认为UC的发病机制主要与肠道菌群失调、免疫异常等因素相关,而肠道菌群的失调又被认为与中医学中“气血水失调理论”不谋而合。因此文章试从气血水理论入手,认为气滞、血瘀、水停是UC发病的重要病机之一,发病初期多为气滞所致,瘀血、水饮既为病理产物又为致病因素,促进疾病的发作或复发。临证治疗时当遵循“调气活血利水法”原则,气、血、水并调是治疗的关键,同时注重健脾、疏肝、补肾等治疗,健脾益气可重用黄芪、党参、白术等,活血利水当用当归、川芎、白芍、茯苓、泽泻之品。文章从气血水理论源流,气血水理论在UC发病及治疗中的应用等方面,结合古今医家之见,探讨调气活血利水法治疗UC的辨证思路,为UC的临床治疗提供理论支持。Ulcerative colitis(UC),a prevalent and intricate chronic digestive disorder,shares significant associations with traditional Chinese medicine’s“diarrhea”and“hematochezia.”Despite ongoing research,a definitive cure remains elusive,largely due to its characteristic relapses and chronicity,which severely impact public health.Modern medical perspectives attribute UC’s pathogenesis primarily to intestinal microbiota dysbiosis and immune dysfunction,which intriguingly aligns with the traditional Chinese“qi,blood,and water imbalance”theory.This paper delves into UC’s etiology through the lens of qi,blood,and water theory,positing that qi stagnation,blood stasis,and water retention are pivotal pathogenic factors.Qi stagnation is identified as a primary initiator,with blood stasis and water retention acting as both pathological manifestations and catalysts for disease exacerbation or relapse.Clinical management of UC is guided by the principle of“promoting qi circulation,activating blood circulation,and enhancing diuresis.”A holistic approach is emphasized,focusing on the simultaneous regulation of qi,blood,and water.This strategy incorporates methods to strengthen the spleen and boost qi,soothe the liver and nourish blood,and tonify the kidney to promote diuresis.Key herbal remedies for spleen and qi enhancement include Astragalus,Codonopsis,and Atractylodes.For the integrated treatment of blood and water,Angelica,Ligusticum chuanxiong,Paeonia lactiflora,Poria,and Alisma are recommended.By synthesizing insights from both ancient and contemporary medical scholars,this article elucidates a dialectical therapeutic approach to UC,centered on the promotion of qi,blood,and water harmony.This exploration aims to offer novel perspectives and methodologies for the clinical management of UC,enriching the existing body of knowledge in this field.

关 键 词：气血水理论 溃疡性结肠炎 调气 活血 利水 

分 类 号：R256[医药卫生—中医内科学]