蒋健运用麻子仁丸辨治脾约证经验探析

JIANG Jian's experience further analysis on spleen constipation syndrome by Maziren Pills

文章通过案例进一步介绍蒋健教授用麻子仁丸治疗脾约证尿频、尿失禁的诊疗学术观点。蒋健教授认为:现代医学确有一些疾病可以表现出脾约证大便鞭和小便数的临床特点,凡是大便鞭和小便数在病机上存在某种程度因果关联的疾病,可按脾约证用麻子仁丸治疗;大便鞭和小便数偶然同时出现、并不存在因果关联的疾病,并不支持将之看作是脾约证;判断大小便有无因果关联只能通过用麻子仁丸治疗以后大便鞭与小便数同步改善来倒推。脾约证有时可但有小便数而并无大便鞭,其证据是对此用麻子仁丸治疗以后小便数能够得到改善。这个观点的临床意义在于,对小便数进行一般辨证论治难以取效时,毋忘脾约证的可能性而可试用麻子仁丸进行治疗。脾约证小便数除了小便次数增加外,还包括小便难以忍耐甚或遗尿、尿失禁。

By listing proven cases,this article further analyzed that professor JIANG Jian's academic viewpoint on the treatment of frequent urination and urinary incontinence of spleen constipation syndrome with Maziren Pills.Professor JIANG Jian believes that there are some diseases in modem medicine that can show the clinical characteristics of sparse stool and urinary tract with the syndrome of spleen constipation.If there is causal relationship between constipation and urine count in the pathogenesis,Maziren Pills can be used to treat the disease according to the syndrome of spleen constipation.However,professor JIANG Jian does not think it as spleen constipation syndrome that constipation and frequent urination appear by chance,or there is no causal association between the disease.So,whether constipation and frequent urination are based on some causal relationship in the pathogenesis can be only judged by the result,which shows constipation and frequent urination are both improved after treatment with Maziren Pills.Sometimes only frequent urination without constipation can also be diagnosed spleen constipation syndrome,and the most powerful evidence is that only frequent urination is improved after treatment with Maziren Pills. The clinical significance of this view is that we should not forget the possibility of spleen constipation syndrome and then try to treat frequent urination with Maziren Pills when it is hard to get curative effect after general syndrome differentiation treatment. Frequent urination of spleen constipation syndrome not only involve the more frequency of urination,but also refer to withholding urine hardly and enuresis,or even urinary incontinence.