梁超教授基于“魄门亦为五脏使”理论辨治腹泻型肠易激综合征经验

Professor LIANG Chao’s Experience on Treating IBS-D According to the Theory of “the Anus is Regulated by Five-ZANG Viscera”

腹泻型肠易激综合征是临床上的常见疾病,主要症状有腹泻、腹痛以及排便异常。该疾病属于中医"泄泻"的范畴。《黄帝内经》记载"魄门亦为五脏使"的观点,深刻地揭示了大肠末端肛门的启闭受五脏的支配的内涵。梁超教授受到该理论的启发,认为五脏病变均可引起泄泻。梁老在治疗泄泻的临床实践中,着眼整体,善于抓主要矛盾,建立以五脏为中心的综合辨证思维体系。湿邪是引起泄泻发病最重要的发病因素,最易损伤脾胃。因此梁老强调"顾护脾胃"的重要性。泄泻病机复杂,表现为虚实错杂,梁老则采用双向调节方法以兼顾虚实。此外,注重调节气机升降也是梁老辨证思路一大特色。本文最后结合典型病例,探讨梁老对"魄门亦为五脏使"理论的临床应用。

Diarrhea-type of Irritable Bowel Syndrome(IBS-D) is a kind of common diseases.Diarrhea, abdominal pain and abnormal defecation are the cardinal symptom.IBS-D belongs to diarrhea disease in the field of traditional Chinese medicine(TCM).This theory, namely "the anus is regulated by five-Zang viscera" recorded on The Inner Canon of Huangdi has deeply revealed the effect that anus located in the terminal large intestine is governed by five-Zang viscera.A point of view diarrhea could be caused by the diseases of five-Zang viscera, was put forward by Professor LIANG Chao, according to the theory.In clinical practice of treating diarrhea, Professor LIANG was good at grasping principal contradiction, viewing holism.By this, integrated clinical treatise thinking was established based on five-Zang viscera pathology mechanism.Damp is the most important pathogenic factor for diarrhea.Besides, spleen is the most easily injured by it.Therefore, Professor LIANG has emphasized importance of protecting spleen and stomach.The pathology mechanism of diarrhea is complicated, for intermingled deficiency and excess is the characteristic of it.Thus, this method dual-direction regulation had been taken by Professor LIANG to strike balance between deficiency and excess.What’s more, that regulating ascending and descending of Qi activity had been emphasized is also one of the outstanding trait of clinical treatise of Professor LIANG.Clinical application of the theory of Professor LIANG, "the anus is regulated by five-Zang viscera", has been discussed by this paper in the last part combined with a typical case.