从伏邪论治慢性放射性肠炎

Treating Chronic Radiation Enteritis from Fuxie

慢性放射性肠炎潜伏数年、起病隐匿,常遇感而发,病情变化多端,符合伏邪的特点。其基本病机为本虚标实,虚多为脾肾两虚,实多为湿热瘀互结。该病的治疗应兼顾扶正和祛邪两个方面。当外来燥邪作为诱因入侵时,多耗伤人体津液,造成正气不足,无力抵抗外邪,邪气潜伏于体内,影响脾胃升降功能,以致燥湿内生,治以资生丸加减,以益气健脾、祛湿、行气、清热、消食;燥邪侵犯人体,最易耗气伤津液,以致气阴两虚,治以八珍汤加减,以气血双补;生化无源则气血不足,不能推动气血的运行,以致瘀毒内蕴,以清营汤加减治之,活血化瘀、滋阴凉血;脾虚则肝脏相对旺盛,而出现腹痛、腹胀、肠鸣、泄泻,伴有胁腹胀满疼痛等症状,治以痛泻要方加减,以疏肝实脾。此外,久病脾虚易累及肾脏,引发脾肾两虚,可选择四神丸联合参苓白术散丸剂以调补脾肾。

Chronic radiation enteritis is latent for several years,has hidden onset.It often develops as a result of encountering external pathogens,and its condition changes a lot,in line with the characteristics of Fuxie.The basic pathogenesis of this disease is deficiency in origin and excess in superficiality.Deficiency is mostly due to the deficiency of spleen and kidney,while excess is due to the combination of dampness,heat and blood stasis.The treatment of the disease should take into account two aspects:strengthening the body and removing pathogenic factors.When exogenous dryness as an inducement invades the human body,it will consume more body fluid,cause deficiency of healthy qi and inability to resist exogenous pathogens.The pathogenic qi will lurk in the body,affect the ascending and descending function of the spleen and stomach,so that dryness and dampness will be generated internally.Zisheng pill can be used to increase and reduce the dryness and dampness,invigorate the spleen,remove dampness,promote qi,clear away heat and help to digest food;dryness pathogen invades human body,and it is easy to consume qi and hurt body fluid,so that both qi and yin are deficient,and modified Bazhen Decoction can be used to replenish qi and blood;if there is no biochemical source,the qi and blood will not be enough to promote the movement of qi and blood,so that the blood stasis and toxin will be contained in it.It can be treated by modified Qingying Decoction to promote blood circulation and remove blood stasis,nourishe yin and cool blood;spleen deficiency is the relative exuberance of the liver,and abdominal pain,abdominal distention,bowel sounds,diarrhea,accompanied by abdominal distention full pain and other symptoms,and modified Tongxie Yaofang can be used to soothe the liver and strengthen the spleen.In addition,kidney is easily affected by spleen deficiency due to long illness,which leads to spleen and kidney deficiency.We can choose Sishen Pill combined with Shenling Baizhu Powder-pill to regulate spleen and kidney.