摘要
嘈杂病因为内伤饮食、虫毒感染、脏腑失和及他病失治,病机为肝脾不和,气机升降失司。病性分虚实,虚者以脾虚为主,包括阴虚火旺,血虚等;实者以痰火等病邪侵犯脾胃为主,包括肝气郁结,虫毒内侵等。虚证包含血嘈、老人嘈等;实证包含火嘈、痰嘈、虫嘈等。治疗嘈杂的方法有健脾补气法,基础方为六君子汤、二陈汤;滋阴补血法,用四君子汤加白芍养阴补血;清热泄火法,以痰火越鞠丸、加味三补丸、二陈加黄连栀子汤加减。临床运用中,肝火犯胃所致嘈杂,可发展为反胃与泄泻,应条达肝气,补益脾土。吞酸者,常伴嘈杂,两者均为气机升降失常所致。胃痛如伴嘈杂,多为痰饮导致,可按照痰湿胃痛进行治疗。嘈杂虽然有其独立的证治,但更多是其他疾病的先兆,可作为治未病的切入点。
The etiology of gastric upset includes dyspepsia, insect and toxicity infection, disharmony of viscera and other diseases.The pathogenesis is liver-spleen disharmony, and abnormal ascending and descending of qi movement.The nature of the disease is divided into deficiency and excess.The deficiency mainly refers to spleen deficiency, including yin deficiency, excessive fire, blood deficiency, etc.The excess mainly refers to phlegm and fire invading the spleen and stomach, including stagnation of liver qi,internal invasion of insect and toxicity and so on.Deficiency syndrome includes blood gastric upset, old people gastric upset, etc, while excess syndrome includes fire gastric upset, phlegm gastric upset, insect gastric upset and so on.The methods to treat gastric upset are as follows: The first is invigorating the spleen and tonifying qi.The basic formulas are Six Gentlemen Decoction and Two Matured Substances Decoction.The second is nourishing yin and tonifying blood.Four Gentlemen Decoction combined with Baishao(Radix Paeoniae Alba) can be used.The third is clearing heat and purging fire, so Phlegm-Fire Constraint-Resolving Pill, Flavored Three Tonifying Pill, Modified Two Matured Substances Decoction combined with Coptis and Gardenia Decoction.For food retention and insect poison can be treated with helping digestion and expelling parasite respectively.In clinical application, the gastric upset caused by liver fire invading the stomach can develop into regurgitation and diarrhea, which should be treated with soothing the liver qi,tonifying the spleen.Acid vomiting is often accompanied by noise, both of which are caused by abnormal ascending and descending of qi movement.Although gastric upset has its own special syndrome and treatment, it is more a precursor of other diseases and can be used as an entry point for the prevention of diseases.
作者
武可尚京
武孟生
何璐琪
罗云钐
雷海燕
WU Ke-shang-jing;WU Meng-sheng;HE Lu-qi;LUO Yun-shan;LEI Hai-yan(Chengdu University of Traditional Chinese Medicine,Chengdu,Sichuan,China,610072;Xiaogan Wu Meng-sheng Hospital of Traditional Chinese Medicine,Xiaogan,Hubei,China,432000)
出处
《河南中医》
2021年第9期1304-1307,共4页
Henan Traditional Chinese Medicine
关键词
嘈杂
源流
健脾补气法
滋阴补血法
清热泄火法
反胃
泄泻
吞酸
胃痛
gastric upset
origin and development
invigorating the spleen and tonifying qi
nourishing yin and tonifying blood
method of clearing heat and purging fire
regurgitation
diarrhea
acid vomiting
stomachache
