“养心调肠”针法治疗腹泻型肠易激综合征肝郁脾虚证理论探讨

Theoretical discussion on the treatment of diarrhea-predominant irritable bowel syndrome with liver depression and spleen deficiency syndrome by“nourishing heart and regulating intestines”acupuncture

腹泻型肠易激综合征(IBS-D)是以腹部不适、粪便含水量升高、排便习惯改变为主要表现的慢性功能性肠道病,常伴有失眠、疲劳、抑郁和焦虑等非消化道症状。目前多数学者认为心神失调是IBS-D的病机关键。“养心调肠”针法是基于“心小肠藏象系统”理论,结合现代医学的“脑-肠轴”理论而创立的心肠同调的针刺方法,缓解胃肠道症状的同时,得以从根本上解决IBS-D的发生,减少其复发率。该针法临床应用疗效突出,对于各种证型的IBS-D均有良效。其中,以肝郁脾虚证临床最为常见,故基于“心小肠藏象系统”和脑肠轴理论,从脏腑、经络、病机角度探讨“养心调肠”针法治疗IBS-D肝郁脾虚证的理论依据,并为临床治疗IBS-D提供新的思路和方法。

Diarrhea-predominant irritable bowel syndrome(IBS-D)is a chronic functional disease of intestinal tract,which is characterized by abdominal discomfort,increased water content of feces,and changes in bowel movement.It is often accompanied by non-gastrointestinal symptoms,such as insomnia,fatigue,depression and anxiety.At present,most scholars believe that mental disorder is the key to the pathogenesis of IBS-D.The acupuncture method of“nourishing heart and regulating intestine”is based on the theory of“heart and small intestine visceral system”and combined with the theory of“brain-gut axis”in modern medicine.It can not only relieve gastrointestinal symptoms,but also fundamentally solve the occurrence of IBS-D and reduce the possibility of recurrence.The clinical application of this method is outstanding,and it is effective for IBS-D of various syndromes.Among them,liver depression and spleen deficiency syndrome are the most common syndromes in clinic.Therefore,based on the theory of“heart and small intestine visceral system”and brain-gut axis,this paper will explore the theoretical basis of“nourishing heart and regulating intestine”acupuncture in the treatment of IBS-D liver depression and spleen deficiency syndrome from the perspective of viscera,meridians and pathogenesis.What’s more,it will provide new ideas and methods for clinical treatment of IBS-D.