基于“三焦分消”理念分析三仁汤“异病同治”治疗溃疡性疾病的临证思路

Clinical thinking of Sanren Decoction treating different diseases with the same method in the treatment of ulcerative diseases based on the concept of eliminating pathogens in sanjiao

溃疡性疾病是临床中的常见病、多发病,亦是中医优势病种之一。异病同治是中医辨证论治的精髓,其核心是“证同则治同,证异则治异”,若不同的疾病在发展过程中,出现了相同的病机与证候,即可采用同一方法进行治疗。三仁汤是治疗温病湿热证的代表方剂,可通过宣上、畅中、渗下将湿热之邪由三焦分消走泄而去。溃疡性疾病包括口腔溃疡、胃溃疡、溃疡性结肠炎等病,临证之际,“有是证用是方”,若疾病证属湿热蕴结,投以三仁汤治之,疗效颇佳。从疾病“异病同治”的角度出发,基于“三焦分消”理论初步探讨三仁汤在溃疡性疾病中的临床运用,以期为溃疡性疾病的临床治疗提供参考。

Ulcerative diseases refer to a group of common and frequently-occurring diseases in clinical practice,and they are also the dominant diseases of traditional Chinese medicine.Treating different diseases with the same method is the essence of TCM syndrome differentiation and treatment,whose core lies in"administering the same treatment for the same syndrome,while a different one for a different syndrome".If different diseases bear the same pathogenesis and syndrome in their development process,the same method can be used for their treatment.Sanren Decoction,derived from Wenbing Tiaobian(Detailed Analysis of Epidemic Warm Diseases),is a representative prescription for the treatment of warm diseases with the dampness-heat syndrome.The prescription can eliminate the pathogens of dampness and heat from sanjiao by ventilating the upper jiao,activating the middle jiao and promoting diuresis in the lower jiao.There are many kinds of ulcerative diseases,including oral ulcer,gastric ulcer,ulcerative colitis and other diseases.When dealing with a specific syndrome,it is advisable to adopt the treatment principle of"treating a certain syndrome with a definite proper prescription".Therefore,if an ulcerative disease manifests a syndrome of dampness-heat amassment and Sanren Decoction is used to treat it,a good curative effect will be achieved.From the perspective of"treating different diseases with the same method,this paper preliminarily discusses the clinical application of Sanren Decoction in the treatment of ulcerative diseases based on the theory of"eliminating pathogens in sanjiao by diaphoresis and purgation respectively",aiming to provide a reference for the clinical treatment of ulcerative diseases.