周兰若泄泻痢疾证治经验浅探

Experience in Treating Diarrhea in ZHOU Lanruo

[目的]探析近代浙江嘉兴名医周兰若泄泻、痢疾证治经验。[方法]通过研读周兰若所存泄泻、痢疾代表性医案,发掘周氏诊治泄泻、痢疾治法特色及用药经验,总结阐述周氏辨治泄泻、痢疾的学术经验。[结果]周氏辨治泄泻治法特色鲜明,如暑湿之泻,清温有别;食滞肠胃,消积导滞;脾虚受邪,扶脾祛邪;久泄责肾,温肾固涩。对痢疾辨治分型分期较为明确,如对外感初痢,行逆流挽舟法;因寒湿、湿食或湿热所致者,采温中化湿、消食导滞、清化湿热之法;而久痢不止者,当涩肠固脱,对休息间痢者,则扶元解毒。[结论]周氏在泄泻、痢疾诊治方面,辨机分明,治法明确,疗效显著,对当今临床类似肠道疾病治疗极具借鉴价值。

[Objective]To explore the experience of treating diarrhea and dysentery from ZHOU Lanruo,a famous doctor in Jiaxing,Zhejiang in modern times.[Methods]Through studying the representative medical records of iarrhea and dysentery stored by ZHOU Lanruo,we explored the character-istics of ZHOU’s diagnosis and treatment of diarrhea and dysentery and his medication experience,summarized and expounded ZHOU’s academic experience in treating diarrhea and dysentery.[Results]ZHOU’s method of treating diarrhea with differentiation and treatment had distinct characteristics,such as diarrhea due to summer-heat and dampness,and clearing temperature is different.Food stagnation in intestines and stomach,eliminating accumulation and leading stagnation;Spleen deficiency is affected by pathogenic factors,and the spleen is strengthened to eliminate pathogenic factors.For a long time,it is necessary to drain the kidney,warm the kidney and strengthen the astringency.The diagnosis and treatment of dysentery are clearly classified into different stages,such as the method of holding boats in counter-current to the external feeling of incipient dysentery.For those caused by cold and dampness,wet food or damp-heat,adopt the methods of warming and eliminating dampness,resolving food stagnation and clearing damp-heat.For those with persistent dysentery,it helps to detoxify the vigour when astringing the intestine and stopping diarrhea during rest.[Conclusion]ZHOU’s diagnosis and treatment of diarrhea and dysentery has clear mechanism,clear treatment method and obvious curative effect,which is of great reference value to the treatment of similar intestinal diseases in clinic today.