龙惠珍教授以斡旋启闭法治疗气虚型习惯性便秘经验

Professor LONG Huizhen’s Treatment of Deficiency of Qi Habitual Constipation with “Woxuan-Qibi” Therapeutic Method

[目的]总结龙惠珍教授运用斡旋启闭法治疗气虚型习惯性便秘的临证经验。[方法]通过跟师临诊,整理病案,查阅相关文献,从病因病机、辨治特色两方面探究龙惠珍教授运用斡旋启闭法治疗气虚型便秘的临证经验,并附临床医案一则以佐证。[结果]龙惠珍教授认为气虚型习惯性便秘之病因多为饥饱劳役,内伤脾胃,其核心病机在于脾胃虚弱,气机升降失常,而致肠腑气机闭塞,燥屎停滞不出。拟法以斡旋中焦,通腑启闭。依法遣方,创制益气升阳通便方加减进行治疗,常用药物黄芪、党参、生白术、升麻、枳壳、火麻仁、秦艽等。所附一则医案,患者呈明显气虚之象,属气虚大肠推动无力、燥屎内结之证,治以斡旋中焦、通腑启闭,兼安神定志之法,投以自拟方,疗效颇好。[结论]龙惠珍教授认为气虚型便秘患者多因劳累过度,饥饱失节,内伤脾胃,日久常现气虚之象,其升清降浊功能受限,大肠传导失司,终致便秘,故常运用斡旋启闭法,投以自拟益气升阳通便方治疗,效果颇佳,值得临床推广运用。

[Objective] To summarize the clinical experience of Professor LONG Huizhen in the treatment of deficiency of Qi habitual constipation by using the"Woxuan-Qibi"therapeutic method. Through collecting,analyzing the medical records and consulting related literature,the thoughts of Professor LONG Huizhen in treatment of deficiency of Qi habitual constipation is discussed from two main aspects of pathogenesis and unique treatment characteristics. One clinical medical record is attached below.[Result] Professor LONG Huizhen considers that the weakness of the spleen and stomach,which leads to the obstruction of the intestinal Qi,is the core pathogenesis of deficiency of Qi habitual constipation. Thus,the proposed method"Woxuan-Qibi"was originated and the Chinese formula Yiqi Shengyang Tongbian Formula was used in the treatment of habitual constipation based on the method for many years. In addition,the formula was composed of Astragalus,Codonopsis,Atractylodes macrocephala,Cimicifuga,Fructus Aurantii,Hemp Kernel,Qin Zhi,etc. Subsequently,the medical record showed obviously that the patient was diagnosed the deficiency of Qi,weakness in pushing the large intestine with treatment by Yiqi Shengyang Tongbian Formula and exhibited exact effect. Professor LONG Huizhen considers that patients with constipation mostly suffer from overwork,hunger,internal injury to the spleen and stomach,and the symptoms of deficiency of Qi often appear along. Their function of ascending and lowering turbidity is limited,and large intestinal conduction loss causes constipation. Accordingly,the treatment of habitual constipation with "Woxuan-Qibi"method and Yiqi Shengyang Tongbian Formula is usually used in the clinical practice with a satisfactory effect.