王宝迎教授治疗肺脾气虚型便秘经验探析

Professor WANG Baoying’s experience in treating constipation of the lung and spleen Qi-deficiency type

功能性便秘是一种常见的消化道疾病,是指排除器质性病变因素及药物所致便秘后,由多种病理生理机制作用所导致的便秘,中医称之为“大便难”。西医主要的治疗手段有改变饮食习惯和生活方式,药物治疗,肠道微生态治疗,生物反馈治疗及手术治疗,但疗效不佳、不良反应多,复发率高。认为便秘辨证以虚实为纲,而虚秘以肺脾气虚型便秘为主。王宝迎主任医师认为肺脾气虚型便秘在中老年患者中较为常见,临床主要表现为便秘,便质干,排便努挣汗出,脘腹胀满,乏力,气短,汗出。王宝迎主任医师根据数十年的临床实践,提出肺脾气虚型便秘为因虚致秘,多为本虚标实,虚实夹杂之证。肺气宣发肃降及脾胃运化能保证肠道传导正常。若肺脾虚弱,则大肠传导失常,发为便秘。治疗肺脾气虚型便秘时应在健脾补肺的基础上润肠通便,攻补兼施,在临床治疗中取得了显著疗效。文章总结导师临床治疗功能性便秘的经验,以期为功能性便秘的治疗提供参考。

Functional constipation is a common digestive tract disease,which refers to constipation caused by a variety of pathophysiological mechanisms after excluding organic lesions and drug-induced constipation.TCM calls this difficult to stool.The main treatment methods of Western medicine include dietary habits and lifestyle,drug treatment,intestinal microbiome therapy,biofeedback therapy and surgical treatment,but the efficacy is not good,there are many adverse reactions and the recurrence rate is high.It is believed that the differentiation of constipation is mainly based on the virtual reality,and the deficiency constipation is mainly based on the deficiency of lungs and spleen.Chief physician WANG Baoying believes that pulmonary and spleen deficiency constipation is more common in middle-aged and elderly patients,and the clinical manifestations are constipation,dry stool,stool sweating,abdominal distention,fatigue,shortness of breath,and sweating.Based on decades of clinical practice,the instructor proposed that constipation of lung and spleen deficiency is caused by deficiency,and most of them are evidence of virtual and real inclusions.Lung Qi(气)promotion and spleen and stomach mobilization can ensure normal intestinal conduction.If the lungs and spleen are weak,the large intestine conduction is abnormal and constipation occurs.In the treatment of pulmonary and spleen deficiency constipation.It should be laxative on the basis of strengthening the spleen and replenishing the lungs,and both attack and supplement should be applied,and significant efficacy has been achieved in clinical treatment.This paper summarizes the clinical experience of supervisors in the treatment of functional constipation,in order to provide reference for the treatment of functional constipation.