闫永彬治疗小儿食积经验

Yan Yong-bin’s Experience of Treating Food Retention in Children

闫永彬认为,食积不仅是一种疾病,还可作为病邪化热、化郁、化湿,治疗食积不仅要消积导滞,健运脾胃,还需清热、行气解郁、分解湿热、宣畅气机。食积化热证,以清热导滞、消积和中为治则,方用枳实导滞丸加减,一般去大黄,以防其苦寒伤正。食积化郁证,以扶脾开郁、行气消食为治则,常用越鞠保和丸加减,气郁重者加木香、陈皮行气健脾消食;血郁重者加蒲黄、五灵脂活血化瘀;食郁重者加槟榔行气杀虫消积。食积化湿证,以清热化湿、宣畅气机、消食化积为治则,方用三仁汤加减,兼有脾虚者,加太子参清补脾胃。闫老师认为,食积虽属实证,但常虚中夹实,脾常不足为发病之本,平素需注重饮食调护,顾护脾胃,防止食积复发或转化为他证。

Yan Yong-bin believes that food retention is not only a disease,but also one that can transform heat,depression and dampness into pathogens.The treatment of food retention not only needs to eliminate accumulation and guide stagnation,strengthen the spleen and stomach,but also needs to clear away heat,move qi and relieve depression,decompose dampness-heat and promote qi movement.For food retention transforming into heat syndrome,the principle of clearing heat and guiding stagnation,eliminating accumulation and harmonizing the middle energizer is adopted.Modified Immature Bitter Orange Stagnation-Moving Pills can be used,and Dahuang(Radix et Rhizoma Rhei)is generally removed to prevent its bitter cold from hurting the body’s healthy qi.For food retention transforming into depression syndrome,For the syndrome of food accumulation and depression,the treatment principle is to reinforce the spleen and relieve depression,move qi and eliminate food retention.Modified Constraint-Resolving and Harmony-Preserving Pills can be used.For those with severe qi depression,Muxiang(Radix Aucklandiae)and Chenpi(Pericarpium Citri Reticulatae)are added to move qi and strengthen the spleen and eliminate food retention.For those with severe blood depression,Puhuang(Pollen Typhae)and Wulingzhi(Faeces Trogopterori)are added to promote blood circulation and remove blood stasis.For those with severe food depression,Binglang(Semen Arecae)is added to move qi and kill insects and eliminate accumulation.For food retention transforming into dampness syndrome,the treatment principle is to clear heat and resolve dampness,dissipate qi movement and remove food accumulation.Modified Three Kernels Decoction is often used.The prescription is modified with Sanren decoction.For those combined with spleen deficiency,Taizishen(Radix Pseudostellariae)is added to nourish the spleen and stomach by using clearing method.Professor Yan believes that although food retention belongs to deficiency syndrome,it often has the feature of deficiency and excess in complexity.Spleen deficiency is the origin of the disease.We should pay attention to diet care,take care of the spleen and stomach,and prevent the recurrence of food retention from transforming into other syndromes.