河南中医2024，Vol.44Issue(8)：1199-1204,6.DOI:10.16367/j.issn.1003-5028.2024.08.0221
陈康清治疗慢性结肠炎经验
Chen Kangqing's Experience of Treating Chronic Colitis
摘要
Abstract
Chief physician Chen Kangqing believes that spleen and kidney deficiency leading to diarrhea is the main pathogenesis of chronic colitis.Professor Chen uses the theory of"differentiation and treatment of state targets"to treat chronic colitis.Chronic colitis is divided into three stages:inflammation stage,inflammation accumulation and abdominal mass stage,and rehabilitation stage.The patho-logical process of a certain stage of its development is divided into four states:"stagnated fire state,dampness-heat state,cancer toxicity state,and yin fire state".The syndrome differentiation is divided into eight types:spleen and stomach weakness,dampness and turbidity forcing the intestines and viscera type;spleen yang deficiency mixed with cold,cold dampness blocking intestinal type;spleen deficien-cy,sinking of middle energizer qi,and qi deficiency failing to control the large intestine type;liver stagnation and spleen dampness,dampness-heat retention in the gastrointestinal tract type;liver stagnation and spleen deficiency,qi stagnation and blood stasis blocking the large intestine type;spleen deficiency and phlegm obstruction,water dampness and phlegm obstruction in the large intestine type;kidney-spleen yang deficiency and toxin stagnation,yang deficiency and toxin stagnation in the large intestine type;spleen-kidney yin and yang deficiency,toxin and phlegm and dampness and blood stasis stagnation in the large intestine type(cold and heat in complexi-ty),etc.The inflammation stage is characterized by"dampness-heat state"and"stagnated fire state".For those diagnosed with spleen and stomach weakness,dampness and turbidity forcing the intestines and viscera,the treatment is to invigorate the spleen and eliminate dampness,promote the flow of descending grains,and choose Zanglian Pill as the target formula.For liver stagnation and spleen damp-ness,dampness-heat retention in the gastrointestinal tract type,the treatment is to soothe the liver and relieve stagnation,invigorate the spleen and eliminate dampness,promote the descending of the grain channel,and use Bupleurum Liver-Soothing Powder as the target formula.For liver stagnation and spleen deficiency,qi stagnation and blood stasis blocking the large intestine type,the treatment is to soothe the liver and remove blood stasis,invigorate the spleen and eliminate dampness,promote and dredge intestines,so Major Bupleu-rum Decoction,Rhubarb and Peony Decoction,etc.can be used as the target formulas.The stage of inflammation accumulation and ab-dominal mass stage is based on the principle of"cancer toxicity".If the syndrome differentiation is spleen yang deficiency mixed with cold,cold dampness blocking intestinal type,the treatment is to warm yang and invigorate the spleen,dispel cold and remove turbidity,and use Aconite Middle-Regulating Pills as the target formula.For spleen deficiency and phlegm obstruction,water dampness and phlegm obstruction in the large intestine type,the treatment is to invigorate the spleen and eliminate dampness,regulate qi and promote stagnation.The target formula is Two Matured Substances Decoction combined with Ginseng and Poria and White Atractylodes Powder.For kidney-spleen yang deficiency and toxin stagnation,yang deficiency and toxin stagnation in the large intestine type,the treatment is to regulate yin and yang,remove blood stasis,regulate qi and promote stagnation.The target formula is Mume Pill,or Pinellia Heart-Draining Decoction combined with Eupolyphaga seu Steleophaga Pill.At this stage,there is a complex state of weakened internal organs and qi,combined with visible pathogens.If encountering the toxic phlegm and cancerous state combined with abdominal mass,"Banbi-anlian(Herba Lobeliae Chinensis)-Qiyeyizhihua(Rhizoma Paridis)","Pugongying(Herba Taraxaci)-Shancigu(Pseudobulbus Cre-mastrae seu Pleiones)pairs can be added to clear heat and detoxify,reduce swelling and disperse nodules.For phlegm,blood stasis,and toxin accumulation,"Sanleng(Rhizoma Sparganii)-Ezhu(Rhizoma Curcumae)-Dannanxing(Rhizoma Arisaematis cum Bile)","Xue-jie(Sanguis Draconis)-Baifuzi(Rhizoma Typhonii)"pairs can be used to promote blood circulation,remove blood stasis,and disperse phlegm and depression.The rehabilitation stage is based on the principle of"yin fire state".If the syndrome is diagnosed as kidney spleen yang deficiency and toxin stagnation,and yang deficiency and toxin stagnation in the large intestine type,the treatment is to warm the kidney and invigorate the spleen,dispel cold and remove toxins,promote diuresis and reduce swelling,with Spleen-Restoring Decoc-tion and Decoction for Reinforcing the Spleen as the target formulas.For spleen deficiency,sinking of middle energizer qi,and qi defi-ciency failing to control the large intestine type,the treatment is to tonify the middle energizer qi,raise yang and eliminate toxins,with Center-Supplementing and Qi-Boosting Decoction and Eight-Gem Decoction,etc.as target formulas.At this stage,the function of zang-fu organs is weak and the pathogenic factors are gradually eliminated.According to clinical symptoms and target formulas,corresponding target drugs should be added.If there is qi deficiency and fatigue,Hongshen(Radix et Rhizoma Ginseng Rubra),Xiyangshen(Radix Panacis Quinquefolii),etc.can be added.For abdominal mass combined with qi stagnation and food accumulation,Zhiqiao(Fructus Au-rantii),Chenpi(Pericarpium Citri Reticulatae),Qingpi(Pericarpium Citri Reticulatae Viride),etc.can be added to regulate qi move-ment,while Yiyiren(Semen Coicis),stir-fried Baizhu(Rhizoma Atractylodis Macrocephalae),baked Shanzha(Fructus Crataegi)and Shenqu(Massa Fermentata Medicinalis)and Maiya(Fructus Hordei Germinatus),etc.can be added to help digestion.Professor Chen also selects corresponding etiological target drugs,symptomatic target drugs,and targeted drugs based on syndrome differentiation and typing.关键词
慢性结肠炎/脾肾虚致泄/"态靶辨治"理论/四态八型/靶药/陈康清Key words
chronic colitis/spleen-kidney deficiency leading to diarrhea/the theory of"differentiation and treatment of state targets"/four states and eight types/target drugs/medical cases分类
中医学引用本文复制引用
王小国,陈康清..陈康清治疗慢性结肠炎经验[J].河南中医,2024,44(8):1199-1204,6.基金项目
湖南省第四批基层名老中医经验继承工作室项目{[2023]43号} （）
