闫雪洁运用寒热并用法治疗溃疡性结肠炎经验

Clinical experience of YAN Xuejie in treating ulcerative colitis with the theory of combination of cold and heat

溃疡性结肠炎属临床多发且难治疾病之一,病情反复难愈,严重影响患者生活质量,甚至增加癌变风险。本文旨在探析闫雪洁教授基于“寒热并用”理论治疗溃疡性结肠炎辨治思路及用药特色。闫雪洁教授认为寒热错杂、虚实夹杂为溃疡性结肠炎重要病机,临证常见湿热、热毒、瘀血等多种因素共同作用,损伤肠络而成。病久伤及脾肾,正虚邪恋致病情迁延难愈。临床多表现为寒热、虚实错杂之征象,强调活动期以邪实为主,缓解期以正虚为主。治以寒热并用、虚实兼顾为基本准则,临证讲求分期论治、辨察体质、调气和血、调和阴阳。突出统顾寒热虚实,兼顾气血、体质,结合西医诊治优势,以求标本兼治,减少病情反复,达到最佳治疗效果。用方精当,化裁灵巧,效如桴鼓,为今后临床辨证治疗本病提供经验总结与理论参考。

Ulcerative colitis(UC)is one of the most common and refractory diseases in clinic.Patient’s condition is recurrent and hard to recover,which seriously affects the quality of life of patients and even increases the risk of canceration.The purpose of this paper is to analyze Professor Yan Xuejie’s treatment of ulcerative colitis based on the theory of“combination of cold and heat”and the characteristics of the medication.Professor Yan Xuejie thinks that the cold-heat complex,and intermingled deficiency and excess are the important pathogenesis of UC.The clinical symptoms are caused by the common dampness-heat,pyrotoxin,blood stasis and other factors,which lead to the damage of intestinal collaterals.Chronic illness will hurt the spleen and kidney,and the disease can delay to recover due to the asthenic healthy qi with pathogen lingering.The clinical manifestations are mostly mixed with cold and heat,deficiency and excess.She emphasizes that the active period is dominated by exuberant pathogen and the remission period was dominated by asthenic healthy qi.The treatment is mainly based on the combination of cold and heat and the combination of deficiency and reality.Clinical practice stresses treating by stages,distinguishing physique,mediating qi and blood,and reconciling Yin and Yang.In order to reduce the recurrence of the disease and treat both the symptoms and the root to achieve the best therapeutic effect,we should pay attention to the combination of cold and heat,give consideration to both qi and blood,physique and the advantages of combining with the Western medicine diagnosis and treatment.It’s precise in use,flexible in adding and cutting,and effective is special,which can provide experience summary and theoretical reference for clinical syndrome differentiation in the future.