基于《金匮要略》探讨溃疡性结肠炎的辨治

Discussion on Differentiation Treatment of Ulcerative Colitis Based on Synopsis of Golden Chamber

[目的]探讨《金匮要略》溃疡性结肠炎(ulcerative colitis,UC)的辨治,为临床提高疗效提供理论参考。[方法]通过分析相关条文以及现代研究成果,提出《金匮》对于UC的认识,阐述其治疗原则以及相关理法方药的理论依据,根据脉象和相关症状来判断UC预后情况。[结果]UC病因病机包括素体虚弱,感受外邪,或饮食不节,积滞致痢,湿热互结,迫血妄行,或邪正相持,迁延不愈。治疗上应分清表里先后,同时应兼顾脾肾。热盛内滞者应清泻热结、荡涤积滞,湿热互结者应清热解毒、凉血止痢,脾肾阳虚者应温中散寒、涩肠止血。邪实壅盛者预后一般,内邪欲解者预后良好。阳气不复者预后较差。[结论]通过探讨《金匮》中UC的辨治,对于临床治疗UC具有现实意义。

[Objective] In order to provide theoretical references for clinical improvement of curative effect,to discuss the differentiation and treatment of ulcerative colitis in Synopsis of Golden Chamber.[Method]Based on the analysis of relevant articles and current research results ,this paper puts forward the understanding of Synopsis of Golden on UC,elaborates its treatment principles and the theoretical basis of related legal prescriptions.The prognosis of UC was judged according to the pulse condition and related symptoms.[Results]The pathogenesis of UC includes body weakness ,feeling exogenous evils,or improper diet,stagnation and phlegm,dampness and heat,impelling blood to move in a wrong way,long-lasting evils are in line,and prolongs unhealed. Treatment should be divided into the order,while giving consideration to spleen and kidney.Those who are stagnation of heat and stagnation should clear heat and clean up stagnation.Those who are hot and humid should clear away heat and toxin and cool blood to stop dysentery.Those with spleen and kidney Yang defificiency should warm the center to dissipate cold and make astringent bowel hemostasis.The prognosis of those with excessive accumulation of pathogenic factors is general,the prognosis of those with internal pathogenic factors is good,and the prognosis of those with no positive Qi is poor.[Conclusion]By discussing the differentiation and treatment of Synopsis of Golden on UC,it has practical significance for clinical treatment of UC.