摘要
归纳总结中医辛开苦降理论在治疗溃疡性结肠炎的过程中的运用及"半夏泻心汤"及其类方的体会和理解。以半夏泻心汤、生姜泻心汤、甘草泻心汤三方,其均有辛热之干姜和苦寒之芩连。仲景用干姜温中补脾阳,以芩连清胃热。半夏泻心汤类的寒热错杂证是脾寒和胃热两个方面的错杂。脾寒则清阳不升而腹泻下利,胃热不降则呕,脾胃升降之机痞塞于中,心下痞乃成。而见呕、利、痞之证。根据其症状的不同,三方可以变化使用。溃疡性结肠炎病程缠绵,虚实夹杂,攻则伤正气,补则益邪,故必须用"和"剂以治之;本病或虚或实,"湿"的存在往往贯彻始终,或为寒湿,或为湿热。所以,祛湿亦为治疗大法。但李东垣在《脾胃论》中坚决反对治"湿",用"淡渗之剂治之",是因为"病虽即已,是降之又降,是复益其阴而重竭其阳气矣","故必用升阳风药即差"(调理脾胃经验)。在临床实践中,接受《脾胃论》的指导,也收到较好的效果;"瘀血"是病理产物,亦是使病程缠绵的致病物质。治疗上必须阻断产生"瘀血"的原因,清除"瘀血",使病情转入良性的轨道。
Objective ： To elaborately generalize and analyse using the theory of pungent drugs for dispersion and bitter drugs for purgation to teat ulcerative colitis. Methods ： There are dried ginger （ Rhizoma Zingiberis ）, pungent in flavor and warm in propert scutellaria root （Radix Scutellarias ） and eoptis root （Rhizoma Coptidis） bitter in taste and cold in nature in the 3 recipes ,that is, Banxia Xiexin decoction （ Pinellia decotion for purging stomach - fire） , Sheng fiang Xiexin decoction（ Fresh ginger de coction for purging stomach - fire） and Gancao Xiexin decoction （ licorice decoction for purging stomach -fire）. The concurrence of cold and heat syndrome similar to Banxia Xiexin decoction are the concur- rence of both spleen - cold and stomach - heat . spleen - cold leads to lucid Yang failing to rise , hence diarrhea occurs. Stomach - heat may result in failure of decending of the stomach - qi , that it produces vomitting. Since disturbance of the spleen and stomach in ascending and descending causes epigastric fullness, therefore vomitting, diarrhea and felling fullness in the abdomen occur. The 3 recipes are applied variously on the basis of the different Symptoms. Results ： As the course of the disease of ulcerative colitis is long , the disease has the concurrence of both deficiency and excess, elimination easely impairs the vital - qi and reinforcement easely preserves the pathogenic factors, there fore the disease must be treated by mediating recipes. In the course of the disease, whether it is deficiency or excess, damp is always present, which may be either cold - damp or damp - heat, so that eliminating damp is a very importamt therapy. In Treatise on Spleen and Stomach written by LI Dung - yuan , he resolutely opposed treating damp with tasteless dim＇etics, because ＂ using repeatedly the prescriptions having lowering action should make yang - qi to be exhausted , though ying had been recovered, that the wind - drugs had to be used in order to cure diarrhea ＂. The satisfactory results were obtainer on the basis of the directions in Treatise on Spleen and Stomach. Blood stasis is a pathological product and also a substance making the course of the disease to be long, hence the etiologic factors of blood stasis had to be got rid of to make the degree of illness to be relieved.
出处
《中华中医药学刊》
CAS
2008年第11期2336-2340,共5页
Chinese Archives of Traditional Chinese Medicine
关键词
溃疡性结肠炎
辛开苦降
半夏泻心汤
生姜泻心汤
甘草泻心汤
Ulcerative Colitis
Pungent drugs for dispersion and bitter drugs for purgation
Banxia Xiexin decoction
Shengjiang Xiexin decoction
Gancao Xiexin decoction
