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基于"脾为之卫"探讨溃疡性结肠炎的辨治思路

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[目的]探讨溃疡性结肠炎的病因病机及治疗方法,以期为拓展溃疡性结肠炎的辨治思路提供理论依据.[方法]基于对"脾为之卫"理论内涵的梳理,同时结合现代医学对溃疡性结肠炎发病机制的认识,探讨脾脏功能失常与溃疡性结肠炎病因病机的相关性,并根据溃疡性结肠炎病程演变过程中病机的变化,具体论述分期辨治原则及方药.[结果]"脾失于卫"作为溃疡性结肠炎的病机关键,贯穿其各期而为病,故以"助脾复卫"为中心治则,对溃疡性结肠炎进行分期论治,活动期以消积化滞、理脾和卫为法,缓解期以调气疏郁、健脾行卫为法,恢复期以清养生肌、补脾固卫为法.[结论]运用"脾为之卫"理论有助于认识溃疡性结肠炎发病机制与脾脏的密切关系,完善从脾论治溃疡性结肠炎的分期证治法则及具体方药.
Discussion on the Differentiation and Treatment of Ulcerative Colitis from"Spleen Acting as the Guard for Five Zang-Organs and Six Fu-Organs"
[Objective]To explore the etiology,pathogenesis and treatment methods of ulcerative colitis(UC),in order to provide theoretical basis for expanding the differentiation and treatment of UC.[Methods]Based on a review of the theoretical connotation of"spleen acting as the guard for five Zang-organs and six Fu-organs",and the understanding of the pathogenesis of UC in modern medicine,the correlation between spleen dysfunction and UC was explored from the perspective of"spleen losing of guard".Combined with the changes in the pathogenesis of UC during its progression,the principles of differentiation and treatment in each substage were specifically discussed.[Results]The key pathogenesis of UC is"spleen losing of guard",which runs through all stages of the disease.Therefore,it is proposed to use"assisting spleen to restore the function of guard"as the treatment principle.In the active phase,the method of treatment is to eliminate accumulation and transform stagnation,regulate the spleen and defensive Qi.In the remission phase,the method of treatment is to regulate Qi and relieve depression,and strengthen the spleen and promote defensive Qi.In the recovery phase,the method of treatment is to nourish the muscles,and strengthen the spleen and defensive Qi.[Conclusion]The application of the theory of"spleen acting as the guard for five Zang-organs and six Fu-organs"helps to understand the close relationship between the pathogenesis of UC and the spleen,refine the treatment rules and specific prescriptions of UC related to the spleen in each stage.

ulcerative colitisdysenteryspleen acting as the guard for five Zang-organs and six Fu-organsintestinal mucosal barrierthoughts of differentiation and treatmenttreatment based on substage

张迪、张诗嘉、姜德友

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黑龙江中医药大学 哈尔滨 150040

溃疡性结肠炎 痢疾 脾为之卫 肠黏膜屏障 辨治思路 分期论治

国家中医药局龙江医学流派传承工作室建设项目全国名老中医药专家传承工作室建设项目姜德友传承工作室项目

LPGZS2012-14ZHY12-Z095

2024

10.16466/j.issn1005-5509.2024.08.005

浙江中医药大学学报
浙江中医药大学

浙江中医药大学学报

CSTPCD
影响因子：1.049
ISSN：1005-5509
年,卷(期)：2024.48(8)