“诸湿肿满,皆属于脾”在肝性胸水从脾论治中指导意义

The Guiding Significance of “All Dampness and Swelling Belong to the Spleen” in Treating Hepatic Pleural Effusion from the Spleen

病机十九条是中医学诊疗疾病的基本准则,至今仍对临床具有指导意义。其中的“诸湿肿满,皆属于脾”指出水湿、肿满症状的病机关键在脾。肝性胸水病情重,预后差,西医治疗多采用反复放胸水、使用利尿剂,虽有疗效,但显效颇微,病情易反复,且西药易损伤机体。中医治疗通常采取泻肺利水,却易损伤正气,实属治标,难成长久之法。作者以“诸湿肿满,皆属于脾”为指导,探讨肝性胸水形成的病机关键在于脾阳虚衰,强调从脾论治,以此为指导准则,治法采用温阳健脾利水,可选实脾饮、补中益气汤加减,此法既达到逐水的目的,又同时顾护机体正气,体现了中医学的整体观及“治病求本”的治疗思路。在肝性胸水治疗方法中,“诸湿肿满,皆属于脾”指导的温阳健脾利水法切中病机,治标同时治本,临床上对疾病治疗仍有着极大的指导价值。

Pathogenesis Article 19 is the basic criterion for the diagnosis and treatment of diseases in traditional Chinese medicine,and still has guiding significance for clinical practice.Among them,“all dampness and swelling belong to the spleen”points out that the key pathogenes is of dampness and swelling is the spleen.Hepatic pleural effusion is a serious disease with poor prognosis.Western medicine often uses repeated pleural effusion and diuretics.Although it has curative effect,it has little effect,and the disease is easy to recur,and Western medicine is easy to damage the body.Traditional Chinese medicine treatment usually adopts the method of purging the lung and diffusing water,but it is easy to damage the healthy Qi,which is a treatment standard and difficult to grow for a long time.Under the guidance of“all dampness and swelling belong to the spleen”,this paper discusses the pathogenesis of hepatic pleural effusion lies in the deficiency of spleen-yang,emphasizing the treatment from the spleen as the guiding principle.The treatment method adopts the warming Yang,invigorating spleen and promoting water,and the addition and subtraction of solid spleen drink and Buzhong Yiqi decoction can be selected.This method not only achieves the purpose of water drinking,but also takes care of the body’s healthy Qi.It embodies the holistic view of TCM and the treatment thought of“seeking the root of disease”.In the treatment of hepatic pleural effusion,“all dampness and swelling belong to the spleen”guided Wenyang Jianpi Lishui method to cut the pathogenesis,treat symptoms and root causes,clinical treatment still has great guiding value.