郝海蓉基于“木郁达之”论治功能性消化不良  

Hao Hairong's Treatment of Functional Dyspepsia by"Facilitating Stagnant Liver"

作　　者：李一平 张瑶瑶 张博文 王鹏伟 郝海蓉 LI Yiping;ZHANG Yaoyao;ZHANG Bowen;WANG Pengwei;HAO Hairong(Shanxi University of Chinese Medicine,Taiyuan 030024,China;Department of Spleen and Stomach Diseases,The Affiliated Hospital of Shanxi University of Chinese Medicine,Taiyuan 030024,China)

机构地区：[1]山西中医药大学,山西太原030024 [2]山西中医药大学附属医院脾胃病科,山西太原030024

出　　处：《基层中医药》2025年第2期26-31,共6页Basic Traditional Chinese Medicine

基　　金：山西省中医药管理局科研课题计划(2024ZYYC007);山西省基础研究计划(202203021221288);山西省卫健委科研课题计划(2021039)。

摘　　要：功能性消化不良是临床常见的消化系统疾病,根据其餐后饱胀不适和上腹部疼痛不适等临床症状可归于中医“胃痞”“胃脘痛”等范畴。现代医学认为,此病发病多与胃肠运动功能障碍、内脏高敏感、幽门螺杆菌(HP)感染、精神心理因素等有关,多采取对症治疗,但病情易反复,远期疗效不佳。相比而言,中医辨证论治功能性消化不良,临床疗效显著。《素问·六元正纪大论》中记载了“木郁达之”的治病法则,多年来被各医家广泛应用于临床。郝海蓉认为“木郁”是功能性消化不良的关键病因病机,木郁土虚为发病之本,情志失调为重要影响因素,且“脑肠轴”与肝脾致病相关。故其在治疗本病时从“木郁达之”理论出发,内治以疏木扶土法,以柴平汤合逍遥散为主方随症加减,外治辅以揿针疗法,再加以心理疏导,个体化治疗,可明显改善患者症状,临床取得了较好疗效。Functional dyspepsia(FD)is a common digestive system disease in clinical practice.According to the clinical symptoms such as postprandial fullness and abdomen pain,FD can be classified into the categories of"stomach numbness"and"epigastric pain"in traditional Chinese medicine(TCM).Modern medicine thinks the disease incidence is mainly related to gastrointestinal movement dysfunction,high visceral sensitivity,helicobacter pylori(HP)infection,and mental and psychological factors,and symptomatic treatment is usually adopted.The illness can easily recur,and the long-term curative effect is poor.In contrast,TCM syndrome differentiation and treatment of FD have significant clinical effects.The treatment rule of"facilitating stagnant liver"was recorded in the Six Yuan Zhengji Da Lun of Basic Questions,which has been widely used in clinical practice by physicians for many years.Hao Hairong believed that liver stagnation was the key cause and pathogenesis of FD,and liver stagnation and soil deficiency were the root of the disease;emotional disorder was an important influencing factor,and the brain-gut axis was related to the pathogenesis of liver and spleen diseases.Therefore,in the treatment of this disease based on the theory of"facilitating stagnant liver",the internal treatment focuses on dredging the liver and strengthening the spleen,combined with modified Chaiping Decoction and Xiaoyao San as the main prescription.The external treatment is supplemented with acupuncture therapy,and joint psychological counselling and individual treatment can obviously improve the symptoms of patients,with good clinical effects.

关 键 词：功能性消化不良 木郁达之 疏木扶土 郝海蓉 临床经验 

分 类 号：R256.3[医药卫生—中医内科学]