秘从气治

Treatment of Functional Constipation Based on Qi

便秘多因饮食不节、情志失调、外邪犯胃、禀赋不足导致热结、气滞、寒凝、气血阴阳亏虚等引起肠道传导失司。病机为大肠传导失常,大肠传导全赖气升降出入运动和气濡养温煦作用,即肝升肺降,脾升胃降和肾气濡养及温煦作用。便秘之症首见《黄帝内经》;《伤寒论》称为"脾约","燥屎"等;便秘一词首见《杂病源流犀烛》;《症因脉治》云:"若元气不足,肺气不能下达,则大肠不得传道之令,而大便亦结矣"。治疗上注重秘从气治,糟粕在大肠内传导,主要依靠脏腑之气升降出入运动,表现在升其清阳,降其浊阴,摄取营养,排出所弃,及气的濡养和温煦作用。气的病理形式主要表现为气虚和气滞。"人之有生,无非受天地之气化耳",补气与行气同时,尚需注意,气虚则无以行,故行气之前当先补气,过补当防滋腻,故补气之余不忘行气。补而不腻,行而不过。

Functional constipation is due to improper diet, emotional disorders, external evil attacked the stomach, deficiency of the body leads to accumulation of heat, qi stagnation, cold coagulation, yin , yang, qi and blood deficiency caused by the dysfunctional conduction of the large intestine. The pathogenesis is the irregular conduction of the large intestine. The conduction of the large intestine depends on the motions of ascending, descending, exiting, entering and the warming and nourishing function of Qi. That is the liver Qi ascending and the lung Qi descending;the spleen Qi ascending and the stomach Qi descending, and the nourishment of kidney Qi. It has a long history of medicine origin. The words of constipation first appeared in the Origin of rhino candle and miscellaneous diseases;Treatise on Febrile Diseases named it by “Splenoasthenic constipation”, “dry stool” . etc ; The Etiology of pulse treatment said “If the primordial qi is insufficiency , then the lung Qi cannot descend, the conduction of the large intestine is irregular and the stool will be node.” We should lay emphasis on treating the constipation based on human Qi. The conduction of the stool in the large intestine mainly depends on the motion of viscera Qi. It manifested in ascending the clear yang, descending the turbid yin, intaking the nutrients , removing the abandoned, and the warming and nourishing function of Qi. Pathological form of qi can mainly divided into Qi deficiency and Qi stagnation. “Man＇ s life, because of Qi.” At the same time we tonifying Qi and promoting the circulation of qi , we should also pay attention to the therapy. If Qi is deficiency, we have nothing to promote. So we should tonifying Qi before promoting the circulation of it. Excessive tonifying should in case of greasy, so we should not forget to promote the circulation of Qi when tonifying it. We should tonify and promote the circulation of Qi moderately. Both of the two methods always be used together.