钦丹萍运用健脾祛湿法治疗久泻经验

Professor QIN Danping's Experience in Treating Long-term Diarrhea with the Method of Fortifying the Spleen and Dispelling Dampness

总结钦丹萍教授运用健脾祛湿法治疗久泻的经验。认为久泻以脾虚湿盛为基本病机,临证首要以健脾祛湿为主,提出脾土运化,得阳易健,可运用温脾、化湿、燥湿、利水、温肾等法,可联用淡渗升清药物分利水谷,常用薏苡仁-防风药对淡渗升清;其次重视脏腑联系,肝脾不和者常用柔肝、疏肝法,强调结合心理疏导,肺肠不调者常用四味芍药散宣肺升清;同时不忘虚实寒热,虚实相间者,补虚泻实,养阴与祛湿并重,寒热错杂者平调寒热,清热与祛寒兼顾,其中寒热互结证以半夏泻心汤、生姜泻心汤、甘草泻心汤加减,上热下寒证以乌梅丸加减。

This paper summarized professor QIN Danping's experience in treating long-term diarrhea with the method of fortifying the spleen and dispelling dampness.Spleen deficiency and dampness excess is the basic pathogenesis of long-term diarrhea,and thus the treatment method is mainly fortifying the spleen and dispelling dampness.As the spleen earth governs transportation and transformation,its deficiency tends to be supplemented with yang,and the method of warming spleen,removing dampness,drying dampness,promoting urination,and warming kidney can be used,together with bland medicinals to percolate and raise clear yang and to drain water and grain such as the herbal pair of Yiyiren(Semen Coicis)-Fangfeng(Radix Saposhnikoviae).Besides,it is suggested to put focus on the correlations between zang fu(脏腑)organs.For liver-spleen disharmony,the method of softening the liver and soothing the liver is commonly used,and psychological counseling can be considered.For lung-intestine irregularity,Siwei Shaoyao Powder(四味芍药散)is usually used to diffuse the lung and raise clear yang.Simultaneously,the harmony between deficiency and excess,cold and heat should be considered.For deficiency and excess integration,it is suggested to supplement deficiency and dispel excess,and pay equal attention to nourishing yin and dispelling dampness.For cold and heat in complexity,combination of cold and warm medicinals is suggested,and clearing heat and dispelling cold are both important;in terms of binding of cold and heat,Banxia Xiexin Decoction(半夏泻心汤),Shengjiang Xiexin Decoction(生姜泻心汤),and Gancao Xiexie Decoction(甘草泻心汤)in their modifications can be used;in terms of upper heat and lower cold,Modified Wumei Pill(乌梅丸加减)is advised.