张慧敏基于“肝脾同调”辨治小儿肠系膜淋巴结炎

Chief physician ZHANG Huimin’s experience in differentiating and treating infantile mesenteric lymphadenitis based on the theory of harmonization of liver and spleen

小儿肠系膜淋巴结炎是常见于反复呼吸道或胃肠道感染后,肠系膜淋巴结受刺激而非炎性增生所致的儿科常见腹痛性疾病,多见于7岁以下小儿,好发于冬春季节。应用抗感染及相关对症治疗可缓解症状,然而其病势缠绵往往使患儿深受困扰。中医内治法可解除病痛、减少复发,而无败伤脾胃之虞。张慧敏主任医师认为肝舒脾运,气血调和则安,肝郁脾滞,气血失和则病。究其病位在脾胃,与肝相关,失于肝脾则有碍于气机升降出入,故其治疗在复脾胃运化外亦需转气机升降之轴,调五行生克之变。导师张慧敏主任医师以整体观念为指导,谨守病机,坚持辨病、辨证相结合,认为本病可以从肝论治,着重于调和肝脾、畅达气机,取痛泻要方之义,自拟香楂术芍和肝方,方药精简且疗效显著。

Pediatric mesenteric lymphadenitis is a common pediatric abdominal pain disease caused by stimulation of mesenteric lymph nodes after repeated respiratory or gastrointestinal infections,rather than inflammatory hyperplasia,and is more common in children under 7 years of age,and is more common in winter and spring.Anti-infective and related symptomatic treatments can relieve symptoms,but the persistence of the disease is often distressing for children.TCM internal treatment can relieve pain and reduce recurrence without the risk of damaging the spleen and stomach.Chief physician ZHANG Huimin believes that the liver relaxes the spleen and luck,the harmony of Qi(气)and blood is safe,the liver is depressed and spleen is stagnation,and the loss of Qi and blood is disease.The disease is located in the spleen and stomach,which is related to the liver,and the loss of the liver and spleen hinders the lifting and access of the Qi movement,so its treatment also needs to transfer the axis of the Qi movement to restore the spleen and stomach movement,and adjust the change of the five elements.ZHANG Huimin,the instructor,is guided by the overall concept,adheres to the disease mechanism,adheres to the combination of disease differentiation and differentiation,believes that the disease can be treated from the liver,focusing on harmonizing the liver and spleen,unblocking the Qi movement,taking the meaning of the key prescription for pain and diarrhea,the Xiangzha Zhushao Hegan prescription(香楂术芍和肝方),the prescription medicine is streamlined and the effect is remarkable.