国医大师杨春波辨治慢性泄泻经验

Experience of National TCM Master Yang Chunbo in Syndrome Differentiation and Treatment of Chronic Diarrhea

杨春波教授为全国第三届国医大师,擅长诊治脾胃相关疾病。杨老认为“脾胃湿热”是慢性泄泻的重要病机,湿热久稽、脾肾不足、肝失疏泄是慢性泄泻缠绵难愈、易于复发的关键。临床上,杨老重视察舌诊脉,认为应从“三因制宜”角度辨识慢性泄泻,善以虚实寒热、体质脏腑为辨证纲目,强调辨证过程需重视虚实主次关系,处方用药善清化湿热,并灵活佐以健脾益肾、理气舒络、运脾消导、安神之法。本文结合杨老治疗慢性泄泻的验案,阐述杨老辨治本病的临证思路,以期对临床诊治有所启发。

Professor Yang Chunbo,the third national master of TCM,specializes in diagnosis and treatment of spleen and stomach related diseases.He points out that the important pathogenesis of chronic diarrhea is“spleen-stomach damp-heat”.The key reason why chronic diarrhea tends to relapse and hard to heal is long-time retention of dampness and heat,spleen-kidney deficiency and liver dysfunction of conveyance and dispersion.In clinic,Professor Yang attaches great importance to the tongue and pulse diagnosis,considers that chronic diarrhea should be distinguished and understood from the perspective of“treatment in accordance with three categories of etiologic factors”.He is good at using asthenia and sthenia,cold and heat,constitution,and viscera as the outline of syndrome differentiation,and emphasizes the primary and secondary relation of deficiency and excess.Professor Yang is expert at prescribing and medication to clear away heat and dampness combined flexibly with the methods of strengthening the spleen and benefiting kidney,regulating qi and dredging meridian,helping the transforming function of the spleen,promoting digestion,removing food retention and tranquilizing the mind.This article elaborated on Professor Yang’s clinical thinking of syndrome differentiation and treatment on this disease by combining his cases of treating chronic diarrhea in the hope of enlightening clinical diagnosis and treatment.