杨晋翔教授从“肝主疏泄”论治便秘经验
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摘要
便秘为临床常见疾病,常反复发作,严重影响着人们的生活质量。杨晋翔教授认为便秘虽系大肠传导失职,而病位实在胃肠,二者在五行中皆属土,为至阴之类。脾胃大小肠至阴之类能够正常运转必非赖其本身,而实赖于其他脏腑阳气的推动作用,其中肝主疏泄功能发挥着重要的作用。肝主疏泄功能有着丰富的内涵,从肝的生理特性出发,不仅在于"肝主升"可条畅情志、气机,来辅助实现脾胃之运化功能,还在于"肝主动"来发动一身少阳之气,推动脾胃脏腑的正常运行,故肝与便秘的发生有着重要关系。基于此,在治疗方面杨晋翔教授从"肝"论治,多采用舒肝通阳以去腐秽、清肝泻火、清利湿热、补血润肠等方法。从肝论治便秘,丰富了便秘的治则理论,对于临床施治便秘有一定的借鉴和指导意义。
Constipation often occurs repeatedly in clinical,which seriously affects people's quality of life. Professor YANG Jin-xiang believes that although constipation is caused by neglect of bowel conduction,the disease location is really gastrointestinal. In the five elements,stomach and intestines belong to the earth,which are to the yin. The normal operation of them does not only depend on itself,but also on the promotion of other viscera and Yang qi,of which liver controlling dispersion plays an important role. Liver controlling dispersion function has rich connotation. From the point of view of the physiological characteristics of the liver,it is not only because the main liver elevation can regulate the emotion and vital qi to assist the function of spleen and stomach,but also because the"liver initiative"to activate the qi of Shaoyang and promote the normal operation of spleen,stomach and viscera. Therefore,there is an important relationship between liver and constipation. Professor YANG Jin-xiang treats constipation mostly from the"liver"treatment,using the method of Shugantongyang to remove excessive fetter,clear liver fire,clear moist heat,enriching blood and moistening intestines. Treating constipation from the liver not only enriches the theory of constipation,but also has certain reference and guiding significance for its clinical treatment.
Constipation often occurs repeatedly in clinical,which seriously affects people's quality of life. Professor YANG Jin-xiang believes that although constipation is caused by neglect of bowel conduction,the disease location is really gastrointestinal. In the five elements,stomach and intestines belong to the earth,which are to the yin. The normal operation of them does not only depend on itself,but also on the promotion of other viscera and Yang qi,of which liver controlling dispersion plays an important role. Liver controlling dispersion function has rich connotation. From the point of view of the physiological characteristics of the liver,it is not only because the main liver elevation can regulate the emotion and vital qi to assist the function of spleen and stomach,but also because the"liver initiative"to activate the qi of Shaoyang and promote the normal operation of spleen,stomach and viscera. Therefore,there is an important relationship between liver and constipation. Professor YANG Jin-xiang treats constipation mostly from the"liver"treatment,using the method of Shugantongyang to remove excessive fetter,clear liver fire,clear moist heat,enriching blood and moistening intestines. Treating constipation from the liver not only enriches the theory of constipation,but also has certain reference and guiding significance for its clinical treatment.
引文
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[3]汤立东,王学良,王垂杰,等.李玉奇教授治疗便秘经验[J].世界中医药,2013,8(8):932-934.
[4]何雯玉,周青.朱秉宜老中医治疗功能性便秘经验点滴[J].时珍国医国药,2016,27(11):2756-2757.
[5]苏凤哲,李福海.路志正教授从脾胃论治便秘临床经验[J].世界中西医结合杂志,2009,4(11):761-764.
[6]陈英杰.“肝与大肠相通”探析[J].中医研究,2007,20(11):3-9.
[7]李东垣.脾胃论[M].北京:中国中医药出版社,2007:60.
[8]叶天士.临证指南医案[M].北京:人民卫生出版社,2006:8.
[9]肖元宇,李青.肝气、肝火、肝阳、肝风之临床辨析[J].光明中医,2018,33(13):1982-1984.
[10]朱震亨.格致余论[M].北京:人民卫生出版社,2008:8.
[11]于宁,翟双庆.《黄帝内经》之“肝主生发”[J].中华中医药杂志,2014,29(5):1291-1293.
[12]林佩琴.类证治裁[M].北京:人民卫生出版社,2005:53.
[13]唐宗海.血证论[M].北京:人民卫生出版社,2005:37.
[14]黄元御.素灵微蕴[M].太原:山西科学技术出版,2012:50.
[15]唐宗海.金匮要略浅注补正[M].天津:天津科学技术出版社,2010:58.
[16]黄元御.四圣心源[M].太原:山西科学技术出版社,2011:33,91.
[17]刘启鸿,张凯玲,蔡华珠.六经便秘证治辨析[J].世界中医药,2016,11(11):2236-2241.
[18]刘海清,历淑芬,张俊杰,等.四逆散治便秘举隅[J].云南中医中药杂志,2009,30(7):42-43.
[19]戈学凤,郭志玲,安静.穴位贴敷治疗气秘型功能性便秘临床观察[J].西部中医药,2018,31(1):109-111.