基于“五脏一体观”理论探讨针灸治疗腹泻型肠易激综合征辨治思路  

Discussion on Differentiation and Treatment of Diarrhea-predominant Irritable Bowel Syndrome with Acupuncture and Moxibustion Based on the Theory of“Five Viscera Integrated View”

作　　者：王瑶嘉 任媛媛 赵卫锋 WANG Yaojia;REN Yuanyuan;ZHAO Weifeng(Shaanxi University of Chinese Medicine,Xianyang 712046,Shaanxi,China;Xi’an Hospital of Traditional Chinese Medicine,Xi’an 710021,Shaanxi,China)

机构地区：[1]陕西中医药大学,陕西咸阳712046 [2]西安市中医医院,陕西西安710021

出　　处：《辽宁中医药大学学报》2025年第3期113-117,共5页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：国家重点研发计划“中医药现代化”重点专项基金资助项目(2022YFC3500603)。

摘　　要：腹泻型肠易激综合征(diarrheal irritable bowel syndrome,IBS-D)属于中医“腹痛”“泄泻”范畴,病程迁延反复,病因繁杂,与五脏关系密切。“五脏一体观”理论认为五脏之气相通,其脏气输移,皆有次序,均可输注于肠。肝失条达,疏泄失职,肠气受阻;心神失调,统帅失职,母病及子;中焦脾胃失衡,枢机不利,水湿内停;肺气不利,宣降失职,肠腑失约;肾阳虚衰,封藏失职,火不暖土,均可致IBS-D发生。故五脏失调,肠腑失司是IBS-D发生的总病机,中医针灸治疗应以“通调五脏”为治则,同时顺应各脏生理特性,疏肝/平肝以调气,气顺则痛泻止;养心以宁神,神安则诱因消;调脾胃以畅中焦,中焦畅则万物生;宣肺以利气,气行水化则大便实;温肾以助阳,命火得补则本固泻止。针灸组方时万不可拘泥于单脏,应在“五脏一体观”理论指导下,从辨证的角度有侧重地出发,灵活变通,依法组方。终达五脏通调、阴平阳秘、肠安泄止之效。Diarrheal irritable bowel syndrome(IBS-D)belongs to the category of“abdominal pain”and“diarrhea”in traditional Chinese medicine,which has a prolonged and recurring course,complicated etiology,and a close relationship with the five viscera.The theory of“five viscera integrated view”holds that the Qi of the five organs are connected,and the Qi of the five organs can be transferred to the intestines in an orderly manner.Disorder of the liver,the liver insufficiency,resulting in intestinal Qi is obstructed;heart spirit disorder,failure of the commander-in-chief,resulting in mother passing illness to child;imbalance of the spleen and stomach in the middle Jiao,unfavorable pivot,resulting in internal stagnation of water-dampness;unfavorable lung-Qi,and failed to diffuse,resulting in failure of intestinal fortresses;kidney Yang deficiency and failure,loss of kidney sealing,resulting in fire failing to warm earth.All can lead to the development of IBS-D.Disorder of the five viscera and dysfunction of the intestinal system is the general pathogenesis of IBS-D.Acupuncture and moxibustion treatment should be based on the principle of“regulating five internal organs”,while responding to the physiological characteristics of each organ.To clear/calm the liver in order to regulate Qi;when Qi is smooth,pain and diarrhea will stop;nurture the heart to calm the mind,and when the mind is at peace,the triggers will subside;adjust the spleen and stomach to smooth the middle Jiao,the middle Jiao free of all living things;declaring the lungs to facilitate the gas,the gas line of water,then the stools;warm the kidneys to help the Yang,when the vital fire is replenished,the diarrhea stops.Acupuncture and moxibustion formulas should not be confined to a single organ,but under the guidance of the theory of“five viscera integrated view”,and from the point of view of diagnosis,with emphasis,flexibility,and according to the treatment principles to formulate formulas.The final result is that the purpose of harmony of five Z

关 键 词：五脏一体观 针灸 腹泻型肠易激综合征 

分 类 号：R256.34[医药卫生—中医内科学]