基于“肺肠相表里”理论探讨痴呆的病机及治疗

Exploration of the pathogenesis and treatment of dementia based on the theory of“lungs and intestines are interior-exterior connected”

随着全球经济的快速发展,认知障碍疾病发病率逐年升高。中医学对老年呆病有长久的认识,有一定的辨证论治经验。中医基于整体观、脏腑论治,临床多从肝、脾、肾三脏入手,但从娇嫩之肺脏论述较少,文章基于中医脏腑表里相通理论及现代研究,从理论探讨、病机、临床研究三方面分析“肺肠相表里”理论与痴呆病的病因病机、治则治法的关联。肺的主要生理功能是主纳水谷之精气与肺吸入之气,专司呼吸调节,将清气津液输布全身温润肌肤,将上焦之水下输膀胱,百脉得肺气充盈,血液运行畅通,脑清神明。大肠的主要生理功能是吸收肠腑水气,形成排泄糟粕之物。五脏水谷精微有赖肺的宣发输布,助行六腑之大肠排泄糟粕之物;六腑之大肠承担排泄之功能,肠腑洁净有助于肺气宣降,通调水道便于利行。肺与大肠相表里,生理上自发育开始紧密相连,二者来源相同,存在相同的黏膜防御活性肽;肺部疾病以及肠道炎症,共有活性肽表达失常,免疫紊乱,疾病易生。肺肠同治:一者通腑能增进肠道蠕动,使腹压降低,改善肺功能;二者通腑能清肠,促进机体新陈代谢,肺肃降畅通,清气易摄,脑腑清灵,记忆新生。文章基于“肺肠相表里”理论治疗痴呆,为认知障碍的中医药遣方用药提供理论依据。

With the rapid development of the global economy,the incidence of cognitive disorders increases year by year.Traditional Chinese medicine has a long-term understanding of senile diseases and has a certain treatment experience in the dementia.TCM is based on the holistic view and the treatment of Zang-fu organs(脏腑).Clinical treatment mainly starts from the three viscera of liver,spleen and kidney,which rarely relates to the delicate lung.Based on the theory of Zang-fu organs of TCM and the connection between the exterior and the interior as well as modern research,the paper analyzes the correlation between the theory of“the exterior and the interior”and the etiology,pathogenesis and treatment of dementia from three aspects of theoretical discussion,pathogenesis and clinical research.The main physiological functions of the lung are taking the essence of the food and the lung inhalation of the gas,respiratory regulation,transferring the clear Qi(气)body fluid to the whole body to warm and moist skin,transferring the upper jiao water liquid to the bladder,when the lung-Qi is filled with veins,the blood runs smoothly,and the brain functions normally.The main physiological function of the large intestine is to absorb the water and Qi of the gut and form the excretion of dross.Five Zang(脏)organs’running smoothly depends on the transforming and distributing of the lung,the large intestine of the six Fu(腑)organs excretes dross.The large intestine of the six Fu organs undertakes the work of excretion,the intestine is clean,which helps the lung Qi to descend,and facilitates the regulation of the waterway.In the surface of the lung and the large intestine,they are physiologically closely connected from the beginning of development.They come from the same source and have the same mucosal defense active peptide.The common active peptide expression disorders of lung and intestinal and immune disorders are prone to cause diseases.Lung and intestinal treatment simultaneously can not only enhance intestinal peristalsis,reduce abdominal pressure,improve lung function,but also can regulate Fu organs and clear the intestine,and promote body metabolism,when lung Qi descending is unblocked,clear Qi is easy to take,which can clear the brain and improve memory.The treatment of dementia is based on the theory of“lungs and intestines are interior-exterior connected”,which provides a theoretical basis for the use of TCM prescription for cognitive impairment.