从《黄帝内经》脏腑辨证浅论“六腑皆令人泻”
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R256.34

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Brief Analysis on Idea of “All Six Fu- Organs Leading to Occurrence of Diarrhea” from Syndrome Differentiation of Zang-Fu Organs in Huangdi Neijing
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    摘要:

    泄泻病主脏在脾,病位在肠,且与其他脏腑密切相关,有“五脏六腑皆令人泻”之说。现代医家多从五脏辨治泄泻,忽视从六腑论治之重要性。现通过整理分析《黄帝内经》中关于六腑与泄泻的相关论述,从脏腑辨证角度探讨六腑泄泻的中医诊治方法,分别从胃泻、胆泻、小肠泻、大肠泻、膀胱泻、三焦泻进行论述,认为:胃泻宜脾胃同治,参苓白术散为脾胃共治代表方之一;胆泻有虚、热、湿等之分,临证宜兼顾肝胆,安神定志;小肠泻有虚寒、湿热之别,甚或寒热错杂,治疗上可选五苓散、葛根芩连汤、乌梅丸等;大肠泻亦有寒、热、湿、虚之分,临证宜据证用方,如黄芪建中汤、白头翁汤等,甚或因肺热移于大肠而用清燥救肺汤;膀胱泻宜从气化失司着眼,临证可从肾、从肺论治;三焦泄泻则可辨位论治。六腑泄泻,宜用通降法,六腑虚证致泄亦不少见,临证当注重辨证求因、审因论治。

    Abstract:

    Abstract:The diarrhea,whose main related zang-fu organ is the spleen and whose disease location is in the intestine, is also closely related to other zang- fu organs,which can be reflected in an idea of “all the five zang- organs and six fuorgans leading to the occurrence of diarrhea”. Chinese medicine practitioners nowadays treat diarrhea mainly from the five zang-organs based on the syndrome differentiation and treatment,but they overlook the importance of the six fu-organs. By sorting out and analyzing the relevant discussions on six fu-organs and diarrhea in Huangdi Neijing,this paper discusses the diagnosis and treatment of this disease related to six fu- organs in Chinese medicine from the perspective of syndrome differentiation of zang-fu organs,and respectively discusses from the diarrhea related to the stomach,the gallbladder,the small intestine, the large intestine, the bladder and the triple energizer. This paper holds the following viewpoints. The diarrhea related to the stomach should be treated with combined treatment of the spleen and the stomach, and Shenling Baizhu powder is one of its representative prescriptions. The diarrhea related to the gallbladder has different types,such as deficiency,heat and dampness,and Chinese medicine practitioners should take into account the liver and the gallbladder and calm the mind. The diarrhea related to small intestine consists of the types of deficiency-cold and dampness heat,or even intermingling manifestation of cold and heat,and this kind of diarrhea should be treated with Wuling powder,Gegen Qinlian tang and Wumei pills. The diarrhea related to the large intestine also has different types of cold, heat, dampness and deficiency, and prescriptions, such as Huangqi Jianzhong tang and Baitouweng tang, should be applied according to different syndromes in clinical treatment. In more serious cases, in which the lung heat shifting to the large intestine, Qingzao Jiufei tang can be applied. The treatment of the diarrhea related to the bladder should consider its pathogenesis from the dysfunction of qi transformation and in clinical practice, it can be treated from the kidney and the lung. The diarrheas related to the triple energizer should be treated according to the differentiation of disease location. In the treatment of diarrhea related to the six fu-organs,the method of unblocking and purging should be used. The deficiency syndrome of of the six fu- organs is a common cause of diarrhea related to the six fu-organs,and great importance should be attached to the syndrome differentiation to determine the disease cause and treat it based on the disease cause.

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王莎莎,方国栋.从《黄帝内经》脏腑辨证浅论“六腑皆令人泻”[J].新中医,2022,54(4):213-216

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  • 在线发布日期: 2022-02-24
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