摘要
严光俊教授认为,“痞积转化”是肠息肉发生及癌变的重要病机,“痞化为积”的原因归结为两方面:脾虚为“痞积转化”的土壤;湿热、浊毒、痰瘀等病理因素则是“痞积转化”的种子。严教授治疗肠息肉,以通痞消积为治疗原则,“通”最为关键。扶正以补脾、运脾为主要治法,方用四君子汤补健运皆兼顾。若大便干燥用生白术20~30 g,大便溏软者用炒白术12~20 g;气虚兼有内寒者,可用黄芪,兼阴虚或气胀,宜用山药;伴有腹胀,舌苔白腻者,用苍术、厚朴、陈皮、白蔻仁等;脾胃虚寒,可用吴茱萸、肉桂、炮姜等以温脾助运;若虚寒气血凝滞,可加白芍养血,赤芍活血散瘀,木香行气止痛。祛邪以行气调中、化痰活血、除湿清热、化浊解毒为法。行气调中,药用紫苏梗、陈皮、木香、香附、枳壳、厚朴、柴胡、郁金等;化痰活血,宜将活血化瘀药当归、川芎、丹参、赤芍、鸡血藤等与三棱、莪术、金刚藤、山慈菇、浙贝母、瓦楞子、夏枯草、半夏等化痰散结药同用;除湿清热,方用三仁汤、半夏泻心汤;化浊解毒,药用白花蛇舌草、白英、半枝莲、半边莲等,以祛湿之功化其“浊”,以清热之力解其“毒”,同时与芳香化湿之药合用。
According to Professor Yan Guangjun,"stuffiness transformation"is an important pathogenesis of intestinal polyps and carci-nogenesis.The reasons for"the transformation of intestinal polyps into accumulation"can be atributed to two aspects:spleen deficiency is the soil;The pathological factors such as dampness-heat,turbid and toxin,phlegm and blood stasis are the seeds.In terms of intestinal polyp,Professor Yan takes the principle of dredging stuffiness and eliminating accumulation,and"dredging"is the most critical.Rein-forcing the healthy qi to tonify the spleen and activate the spleen is the main treatment,so Four Gentlemen Decoction can be used.For dry stool,20~30g of raw Baizhu(Rhizoma Atractylodis Macrocephalae)is used.For soft stool,12-20 g of stir-fried Baizhu(Rhizoma Atractylodis Macrocephalae)is used.For qi deficiency and internal cold,Huangqi(Radix Scutellariae)is used;if combined with yin de-ficiency or qi distention,Shanyao(Rhizoma Dioscoreae)can beadded;if if combined withabdominal distension,whiteand greasy tongue coating,Cangzhu(Rhizoma Atractylodis),Houpo(Cortex Magnoliae Officinalis),Chenpi(Pericarpium Citri Reticulatae),Baik-ouren(Fructus Amomi Rotundus),etc.can be used.For spleen and stomach deficiency and cold,Wuzhuyu(Fructus Evodiae),Rougui(Cortex Cinnamomi),Paojiang(Rhizoma Zingiberis Praeparatum),etc.can be used to warm the spleen to help transportation.If there are deficiency,cold,qi stagnation and blood stasis,Baishao(Radix Paeoniae Alba)can be added to nourish blood;Chishao(Radix Pae-oniae Rubra)can be added to promote blood circulation and remove stasis;Muxiang(Radix Aucklandiae)is used to move qi and re-lieve pain.In terms of eliminating pathogens,Professor Yan takes moving qi and regulating the middle energizer,resolving phlegm and promoting blood circulation,removing dampness and clearing heat,resolving turbidity and removing toxin as the treatment principle.In order to moving qi and regulating the middle energizer,Zisugeng(Caulis Perillae),Chenpi(Pericarpium Citri Reticulatae),Muxian
作者
徐大志
向彩琼
严光俊
杨春
邹丹
张军
郑新平
XU Dazhi;XIANG Caiqiong;YAN Guangjun;YANG Chun;ZOU Dan;ZHANG Jun;ZHENG Xinping(Jingzhou Hospital of Traditional Chinese Medicine,Jingzhou,Hubei,China,434000)
出处
《河南中医》
2023年第11期1668-1671,共4页
Henan Traditional Chinese Medicine
基金
2022年度荆州市中医药研究所自主选题立项项目(ZZXT2022Y02)
湖北省中医药管理局中医药科研项目(ZY2023F095)。
关键词
肠息肉
“痞积转化”
通痞消积
扶正通痞消积
祛邪通痞消积
严光俊
intestinal polyp
"stuffiness transformation"
dredging stuffiness and eliminating accumulation
dredging and removing stuffi-ness by strengthening healthy qi
dredging and removing stuffiness by eliminating pathogens
Yan Guangjun
