沙静涛从脾胃论治肛窦炎经验

Sha Jingtao′s Experience in Treating Anal Sinusitis from Spleen and Stomach

沙静涛教授认为,脾虚湿滞为肛窦炎发病的主要原因,脾虚乃致病之本,湿热乃致病之标。肛窦炎缠绵难愈且易反复发作,病机关键在于湿热之邪滞留魄门,胶着难解,顽固不化,加之脾虚运化失职,与气血搏结而形成本虚标实之证。沙教授强调,治疗疾病应根据患者的病情缓急,权衡标本而施治,本虚为主,则健脾益气为要辅以祛湿;标实为主,则清热利湿为先,后期辅以扶助正气;虚实并见,则健脾利湿并用,使祛邪不伤正,补虚不留邪。在辨证论治的基础上,同时应遵循外科“消、托、补”的治疗原则,强调内服、外治相结合,每获良效。

According to Professor Sha Jing-tao,spleen deficiency and dampness stagnation are the main causes of anal sinusitis.Spleen deficiency is the root of the disease,and damp heat is the secondary cause of the disease.It is difficult to recover from anal sinusitis and easy to recur.The key to the pathogenesis lies in the retention of the pathogens of damp and heat in the anus.They are intermingled and hard to remove.In addition,it is also due to the dysfunction of spleen deficiency struggling with qi and blood,which forms the syndrome of primary deficiency and secondary excess.Professor Sha stresses that the treatment should be based on the patient's condition,weighing the primary or secondary cause.If the patient's symptoms are mainly deficiency,invigorating the spleen and nourishing qi should be supplemented by removing dampness.If the patient's symptoms are mainly excess,clearing away heat and removing dampness is the first step,and strengthening qi is the second step.If the patient's symptoms are mainly mixed deficiency and excess,invigorating the spleen and removing dampness are used together.The overall goal is to prevent pathogens from injuring healthy qi and to replenish deficiency without retaining pathogens.On the basis of syndrome differentiation and treatment,we should follow the treatment principle of"eliminating,lifting,nourishing"in surgery,and emphasize the combination of internal and external treatment to achieve good efficacies.