内外科互参论治溃疡性疾病

Treatment of ulcerative diseases by interreference of internal medicine and surgery

外科痈疽疮疡与内科溃疡性疾病的联系建立在中医“取类比象”思维之上,“异病同治”“病证结合”理论体现在现代医学治疗消化内科溃疡性疾病方面。消化性溃疡病机多为肝胃不和、肝胃郁热、脾胃湿热、脾胃虚弱,内科主张“从痈论治”;溃疡性结肠炎的病机关键在于“正衰邪盛,脾虚肠痈”,治则以健脾益气、清热化腐生肌为主。外科首方仙方活命饮以及锡类散、生肌散等散剂在临床治疗消化性溃疡、溃疡性结肠炎方面应用广泛,通过对外科方治疗内科溃疡性疾病的临床疗效进行探究,可阐明内外科互参理论价值,构建内外科互参治疗体系,更好地服务于临床。

The relationship between surgical ulcer selection and internal ulcerative disease is based on the thinking of ‘taking analogical images’ in Chinese medicine. The theory of ‘treating different diseases with the same treatment’ and ‘combination of disease and syndrome’ is embodied in the treatment of ulcer disease in gastroenterology in modern medicine. The pathogenesis of peptic ulcer is mainly liver and stomach disharmony,liver and stomach stagnation heat,spleen and stomach dampness heat,spleen and stomach weakness,internal medicine advocates ‘from the carbuncle treatment’;The key pathogenesis of ulcerative colitis lies in ‘positive decline evil rise,spleen deficiency intestinal carbuncle’,and the treatment is based on invigorating the spleen and supplementing qi,clearing heat and changing saprophytic muscle. The first prescription of surgery,Xianfang Huoming Decoction,Xilei Powder and Shengji Powder are widely used in the clinical treatment of peptic ulcer and ulcerative colitis.By exploring the clinical efficacy of surgical prescriptions for treating ulcerative diseases in internal medicine,we can clarify the theoretical value of mutual reference between medicine and surgery,build a treatment system of mutual reference between medicine and surgery,and better serve the clinical practice.