脾胃升降相因对药应用经验

Medication Experience of Couplet Medicines to Reciprocal Causation of Ascending and Descending of Spleen Qi and Stomach Qi

临床巧用药对可以调整脾胃升降功能,从而维护机体气机的升降平衡。升清降浊以畅达气机:党参配半夏,增强降逆化痰之力,用于急慢性胃炎、反流性食管炎、消化性溃疡、功能性消化不良导致的腹胀、泄泻、恶心、呕吐、呃逆、噎膈等症。补中益气汤配旋覆代赭汤,升中气,降胃气,标本兼顾,升降相使,用于因脾虚生痰,痰阻气逆,而见嗳气、呃逆、呕吐等症。僵蚕、蝉蜕配生地黄、泽泻升清降浊,宣发郁热,通利三焦,调畅气机,主要用于邪热充斥内外,郁滞气机,清阳不升,浊阴不降。黄芪配牛膝,补气行气活血兼降气血,用于老年性高血压、妇女血滞经闭及产妇气虚血瘀而致的腹痛、胞衣不下者。疏肝解郁以助脾升胃降:黄连配吴茱萸,疏肝郁,清胃热,辛开苦降,多治疗肝旺乘脾,寒热错杂,升降失司而见之两胁胀痛、吞酸、口苦等症。木香配郁金,疏肝行气以调气机,治疗因肝郁气机失调而致的胸胁胀满刺痛、胸闷、嗳气、腹胀等症。柴胡配枳实增强行气解郁,疏肝和胃之力,临床常用以治疗急慢性胆囊炎、胆结石、肝硬变、肋间神经痛所引起的胁痛以及肝郁气滞而致的腹胀、食后不消等症。补火暖土以振脾胃升降:仙茅配淫羊藿同温补,互促进,使温补肾阳之力倍增,用于慢性结肠炎、溃疡性结肠炎等属脾肾虚寒证。宣泄肺气以展脾胃气化:紫苏梗配连翘泻肺气,除胃痞,散郁滞,用于治疗胃炎日久而致肺胃气逆,咳则作呕,痞满等症。

Teacher Li Jiyan is a famous doctor in Liaoning Province. He is good at using medicines to adjust the function of the spleen and stomach,so as to maintain the balance of the body’s qi movement. Ascending clear and descending turbidity is to promoteqi movement. Dangshen combined with Pinellia ternata can enhance the ability of reducing adverse reactions and resolving phlegm. It can be used for acute and chronic gastritis,reflux esophagitis,peptic ulcer,abdominal distension,diarrhea,nausea,vomiting,hiccup and diaphragm caused by functional dyspepsia. Buzhong Yiqi Decoction combined with Xuanfu Daizhe Decoction can elevate middle qi,lower stomach qi,give consideration to both manifestation and root cause and getreciprocal causation of ascending and descending. It can be used for phlegm due to spleen deficiency,phlegm obstructing qi reversion,and other symptoms such as belching,hiccup and vomiting. Bombyx batryticatus,cicada slough compatible with Rehmannia glutinosa and Alisma orientalis has the functions of ascending and clearing away turbidity,promoting stagnant heat,clearing away three energies and regulating qi.It is mainly used to treat diseases in which the evil heat is filled with internal and external stagnation,stagnation of qi movement,Qingyang does not rise,and turbidity does not fall. Astragalus combined with Achyranthes has the effect of tonifying qi and activating blood circulation and reducing blood. It is used to treat senile hypertension,women with blood stasis and amenorrhea,and abdominal pain and vestibule caused by maternal qi deficiency and blood stasis. Soothing liver and relieving depression is to assist ascending stomach and descending spleen qi. Coptis chinensis combined with Evodia rutaecarpa has the functions of soothing liver depression,clearing stomach heat,acrid opening and bitter downbearing. It mostly treats the symptoms of liver exuberance,spleen enjoyment,cold and heat miscellaneous,swelling and pain of both sides,acid swallowing and bitterness of mouth. Bupleurum chinense combined with Fructus Aurantii has the effect of promoting qi and relieving depression. It has the effect of dispersing stagnated liver qi for regulating stomach. It is commonly used to treat hypochondriac pain caused by acute and chronic cholecystitis,gallstone,cirrhosis of liver,intercostal neuralgia,abdominal distention caused by stagnation of qi due to liver qi depression and postprandial inactivation. Tonifying yang to warm spleen is to vitalize spleen and stomach. The compatibility of Curculigo and epimedium has the function of promoting each other’s warming and tonifying function,doubling the strength of warming and tonifying kidney-yang. It is used to treat chronic colitis and ulcerative colitis,which belong to the syndrome of deficient cold of spleen and stomach. ventilating lung qi is to promote spleen-stomach gasification. Purple perilla stem combined with Forsythia suspensa has the function of purging lung qi,removing gastric rubella and dispersing depression stagnation. It is used to treat the pneumogastric qi inversion caused by gastritis for a long time,while cough is nausea,fullness and other symptoms.