论应用辛开苦降法治疗溃疡性结肠炎.docVIP

论应用辛开苦降法治疗溃疡性结肠炎摘 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。? 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? 中图分类号：R259.746.2文献标识码：A 文章编号：1673-7717(2008)11-2336-05 ? Discussion of TreatmentofUicerative Colitisby Means? ofthe Therapy UsingPungentDrugs forDispersionandBitter DrugsforPurgation? ZHOUJian?hua?1，ZHIChen?yang?1，LangBing?2? （1.The First AffiliatedHospitaltoChangchunUniversityofChineseMedicine,Changchun 130021,Jilin,China;? 2.Changchun Publical Traffic Hospital,Changchun 130021,Jilin,China ）? Abstract：Objective: Toelaboratelygeneralizeandanalyseusingthetheoryofpungentdrugsfordispersionandbitterdrugsforpurgationtoteatulcerativecolitis. Methods:Therearedriedginger(RhizomaZingiberis ), pungentinflavorand warminpropert scutellariaroot(RadixScutellarias )andcoptisroot(RhizomaCoptidis) bitterintasteandcoldinnatureinthe3recipes,thatis, BanxiaXiexindecoction(Pinelliadecotionforpurgingstomach-fire) ,Sheng jiang Xiexin decoction( Fresh ginger de coctionforpurgingstomach-fire)and GancaoXiexindecoction(licoricedecoctionforpurgingstomach-fire).Theconcurrenceofcoldandheatsyndromesimilarto BanxiaXiexin decoctionaretheconcurrenceofbothspleen-coldandstomach-heat . spleen-coldleadstolucidYangfailingtorise , hencediarrheaoccurs . Stomach-heatmay resultinfailureofdecendingofthestomach-qi , thatitproduces vomitting.Sincedisturbanceofthespleenandstomachinascendinganddescendingcausesepigastricfullness,thereforevomitting,diarrheaandfellingfullnessintheabdomenoccur .The3 recipesareappliedvariouslyonthebasisofthedifferentSymptoms. Results: Asthecourseofthediseaseofulcerativeco