便秘选药的多重思考.docVIP

精品论文 参考文献 便秘选药的多重思考 王通 谢航通讯作者 　　（河南中医学院第一临床医学院中医内科硕士研究生2014级；河南郑州450000） 　　摘要：便秘可见于各类人群，其病位在大肠,其发生不惟与五脏关系密切，而且与个人体质、年龄性别、病情的轻重缓急、经络的循行等息息相关，临床上便秘的证型错综复杂，虽然可选用的通便药物种类繁多，当按常规治疗效果不理想时，怎样多角度思考选药、如何打开用药思路成为亟待解决的问题。或从五脏角度论治选药, 或分清体质选药，或根据不同年龄的生理特点选药，或依病情的轻重缓急选药，或根据经络循行酌选归经药物及酌选穴位药物贴敷等等。只要运用多重思考，使药物达到最佳的排列与组合，对便秘的治疗才能胸有成竹，进一步达到近期和远期的最佳疗效。 　　关键词：便秘；选药；思考 　　Multiple thinking of constipation 　　Wang Tong,Xie Hang 　　(Henan college of traditional Chinese medicine the first clinical medical college of traditional Chinese medicine internal medicine graduate level 2014, Zhengzhou, 450000) 　　Abstract:Constipation visible to all kinds of people, the disease in Escherichia, did not occur except and viscera closely, and personal physique, age, sex, illness and priorities, meridian circulation is closely related to, clinical constipation syndrome complicated, although optional laxative drug kinds and different, when according to the conventional treatment effect is not ideal, how multi angle thinking drug selection, and how to open up the thinking in administration has become a problem to be solved. Or from the point of view of the five organs theory treatment drug selection, or distinguish the constitution drug selection, or according to the physiological characteristics of different ages to choose the medicine, or in accordance with the priorities of the disease drug selection, or according to the meridian line action selected belong to the drug action and selected acupoint sticking and so on. As long as the use of multiple thinking, to achieve the best permutation and combination of drugs, for constipation treatment to have answers, further to achieve the optimal effects of short-term and long-term. 　　Key words: Constipation； Drug selection；Thinking 　　便秘是指粪便在肠内滞留过久，秘结不通，排便周期延长，或周期不长，但粪质干结，排出艰难，或粪质不硬，虽有便意，但便而不畅的病证。其基本病机为热结、气滞、寒凝、气血阴阳亏虚引起肠道传导失司所致[1]。在临床中，如遇到热秘、冷秘、气秘、气虚秘、血虚秘、阴虚秘、阳虚秘常规选方用药不效时，我们不妨从以下四个方面重新考虑选药，正所谓“穷则变，变则通，通则久”。 　　1从五脏角度论治选药[2] 　　虽然便秘的主要病位在肠腑，基本病变属大肠传导失司，但根据五脏的主要生理机能