从心胆论治肠易激综合征探析

Discussion on Treatment of Irritable Bowel Syndrome from Heart and Gallbladder

肠易激综合征属于功能性胃肠病,以胃肠道症状为临床特征并伴随情志的改变。该病致病因素复杂,其症状极大程度地影响了患者的正常工作及生活,中医虽展现出强大的临床治疗优势,但尚无统一成体系的中医理论阐释。心胆协同失衡是肠易激综合征发病的基本病机,心胆内寄少火、少火生气,统领身之气机,心为火脏,胆主疏泄,少火可引心火下行助胃肠腐熟,并助胆中精汁润滑助运胃肠;心主血,胆疏泄气机,心和胆经络旁通,一阴一阳共为枢经,共同枢调气血、把控开阖,顺调脾胃;心为神之大主,胆为心之辅相,主决断,心胆对脏腑情志起决定性作用;故肠易激综合征从心胆论治会更接近该病的本质。肠易激综合征的发病机理可以从少火运化中焦、经络对脾胃气血的枢转、开阖的调控及情志与心胆和脾胃的关系三个方面阐释,从心胆论治脾胃功能失职,使脾胃得神固,得火荣,得气畅,得力转,则肠道的运转功能自能如常。

Irritable bowel syndrome(IBS)is a functional gastrointestinal disease,which is characterized by gastrointestinal symptoms and emotional changes.The pathogenic factors of the disease are complex,and its symptoms greatly affect the normal work and life of patients.Although traditional Chinese medicine shows strong clinical treatment advantages,there is no unified theoretical interpretation of traditional Chinese medicine.The imbalance of heart and gallbladder is the basic pathogenesis of IBS.The heart and gallbladder have Shaohuo and Shaohuo can dominate the Qi movement of the body.The heart is the fire Zang-organ,and the gallbladder controls soothing and purging.Shaohuo can lead the heart fire down,help the stomach and intestines to transport,and help the essence of the gallbladder to lubricate and transport the gastrointestinal tract.The heart controls the blood,and the heart and gallbladder meridians bypass each other,jointly regulating Qi and blood,controlling the opening and closing.Therefore,the treatment of IBS from heart and gallbladder will be closer to the nature of the disease.The pathogenesis of IBS can be explained from three aspects:Shaohuo transporting and transforming the middle energizer,meridians regulating the Qi movement of spleen and stomach,Qi and blood and opening and closing,and the relationship between emotion,heart and gallbladder,spleen and stomach.The treatment from heart and gallbladder can make spleen and stomach function recover,the spleen and stomach will be strengthened and nourished,the Qi will be smooth and the force will be turned,then the intestinal function will be normal.