从升清降浊论治溃疡性结肠炎

Treatment of Ulcerative Colitis from Perspective of"Ascending Clear Qi and Descending Turbidity Qi"

溃疡性结肠炎多属本虚标实之证。脾胃虚弱、肝失疏泄、肺失宣降、肾失封藏均可影响气机。清阳不升、浊阴不下、气血痰瘀阻滞,大肠传导失司,搏结于肠而发病。因此,本病应以升清降浊为治则。通过补中益气汤、升阳益胃汤以健脾升阳,配伍升麻、柴胡、防风等风药,一则胜湿,一则升发清阳;痛泻要方疏肝健脾、调畅气机,配伍杏仁、旋覆花等肃肺之品肃降肺气;桔梗、麻黄等宣肺,黄芩、黄连、白头翁等宣肺清肠,当归、川芎、白芍等活血化瘀、调和气血;补骨脂、附子、肉桂等温肾以温补脾肾,助其运化,配伍赤石脂、诃子等涩肠止泻。上述各法,从脾、肝、肺、肾论治而调整气机升降,使脏腑调和,泻痢自止。

Ulcerative colitis is mostly the deficiency syndrome with excessiveness in symptoms.All of the following conditions like weakness of the Spleen and Stomach,Liver Qi stagnation,Lung Qi up-going,and Kidney essence loss can negatively affect the Qi activities.Clear Yang Qi not rising,turbid Yin not falling,as well as the blockage of Qi,blood,Phlegm and blood stasis negatively affect the function of the large intestine and cause diseases.Therefore,the treatment principle of the disease should be"ascending clear Qi and descending turbidity Qi".Buzhong Yiqi Decoction and Shengyang Yiwei Decoction can be used to strengthen the Spleen and improve the Yang and durgs such as Shengma(cohosh),Chaihu(bupleurum)and Fangfeng(saponikovia)can be used to repel dampness and to raise clear Yang;Tong Xie Yao Fang can be used to regulate Liver Qi,strengthen Spleen and to regulate Qi movement.In addition,drugs such as Xingren(almond)and Xuanfuhua(inula flower)can be used to descend Lung Qi,Jiegeng(campanulaceae)and Mahuang(ephedra)to spread Lung Qi,Huangqin(scutellaria),Huanglian(coptidis)and Baitouweng(Pulsatilla)to clear intestine Heat,Danggui(angelica),Chuanxiong(ligusticum wallichii)and Baishao(radix paeoniae alba)to promote blood circulation and to reconcile Qi and blood;Buguzhi(psoralen),Fuzi(aconite)and Rougui(cinnamon)to warm Spleen and Kidneys to with its transport function,and Chishizhi(red halloysite)and Kezi myrobalan to stop diarrhea.With the above methods,the Qi movement is adjusted based on the treatment of the Spleen,Liver,Lung and Kidney,so that the internal organs are reconciled and diarrhea stops.