“运脾化浊”思想的临证运用

Clinical application of the idea of“transporting spleen and removing turbidity”

国医大师路志正教授,从医八十余载,崇尚脾胃思想,深入研究并发展了现代湿病理论。运脾化浊理论是其学术思想重要内容之一,20世纪80年代,路志正教授即提出“北方多湿论”,百病皆因湿作祟,其中“内生浊邪”是其湿病理论特色,所谓内生浊邪,是脾胃运化功能失常之产物,亦是人体重要致病因素,包含体内稠浊之精微物质不能转输停滞,以及内生湿浊、痰浊停留,进一步影响气血运行而为病。通过恢复脾胃运化功能治疗浊邪为患,称为运脾化浊。路志正教授在80余载临证实践中,积累了丰富经验,尤其对内生浊邪治疗多以脾胃为中心,并兼顾他脏,所谓持中央、运四旁,用药轻灵活泼,多能取效。运用运脾化浊观念,治疗现代内科疾病,有很好的效果。笔者跟师路志正教授多年,对其运脾化浊理论有一定体悟和研究,本文论述并总结了内生浊邪概念及运脾化浊理论的内容,并将作者运用运脾化浊方法在内科应用的治疗经验进行了阐述和总结,试图说明该理论在现代临床中的重要意义。

Professor Lu Zhizheng,the master of traditional Chinese medicine,has been practicing medicine for more than 80 years.He advocates the idea of spleen and stomach and has researched and developed the modern theory of diseases caused by dampness.The theory of transporting spleen and removing turbidity is one of the important contents of his academic thoughts.In the 1980s,Professor Lu Zhizheng put forward the theory of“more multiple dampness in north China”,and all diseases are caused by dampness.Among them,“endogenous turbid evil”is the characteristic of his theory of diseases caused by dampness.The so-called endogenous turbid evil is the product of the abnormal function of the spleen and stomach,and is also an important pathogenic factor of human body,including the failure of the transport and stagnation of dense and turbid fine substances in the body,and the retention of damp-turbidity and turbid phlegm,which further affect the circulation of qi and blood and cause disease.By restoring the function of spleen and stomach to treat turbid evil,called transporting spleen and removing turbidity.Professor Lu Zhizheng has accumulated rich experience in more than 80 years of clinical practice,especially in the treatment of endogenous turbid evil with spleen and stomach as the center,and take into account other organs,so-called holding the central,transport four sides,light and lively medicine,more effective.Using the concept of transporting spleen and removing turbidity to treat modern internal diseases has a very good effect.The author has some understanding and research on the theory of transporting spleen and removing turbidity with Professor Lu Zhizheng for many years.This paper discusses and summarizes the concept of endogenous turbid evil and the theory of transporting spleen and removing turbidity,and expounds and summarizes the author’s therapeutic experience of transporting spleen and removing turbidity in internal medicine,trying to explain the important significance of this theory in modern clinical practice.