从“毒伏筋膜”理论辨证论治克罗恩病

Treatment of Crohn′s Disease Based on Theory of “Toxin Entrapment of Fascias”

克罗恩病(Crohn′s disease,CD)是一种反复发作的慢性炎症性肠病,文中从“毒伏筋膜”理论分析克罗恩病的辨证论治,认为筋膜是克罗恩病发病的重要病位,其病因源于先天禀赋虚弱和后天劳伤精耗,两者共同促成肾精亏虚、毒伏少阴的始动因素,继而伏毒渐张、外发少阳导致筋膜受损是克罗恩病发病的核心病机。根据疾病不同分期特点,采取分期辨治、清透伏毒的治疗原则,潜伏期温肾藏精、养膜固本以充养膜筋,活动期治在少阳、清透伏毒以安其筋膜,迁延期扶正祛邪、标本兼顾以修复筋膜,并提出柔挛解急、护溃保膜、破缴伏巢的特色治疗方法,以期为中医治疗克罗恩病提供新思路。

Crohn′s disease(CD)is a chronic inflammatory bowel disease that occurs repeatedly.This article analyzed the syndrome differentiation and treatment of CD based on the theory of “toxin entrapment of fascias”.It is believed that the fascia is an important location for the onset of CD,whose etiology is derived from congenital weakness and acquired labor injury,both of which jointly contribute to the initiating factor of kidney essence deficiency and toxin entrapment of Shaoyin.Subsequently,the gradual expansion of toxin entrapment and external Shaoyang leading to fascia damage are the core pathogenesis of CD.According to the characteristics of different stages of the disease,the treatment principles of differentiation and treatment by stages and toxin entrapment removal are adopted.In the latent period,warming the kidney,storing essence,nourishing the membrane,and consolidating the essence were adopted,so as to replenish the membrane and tendons.In the active period,treating the shaoyang and clearing away toxin entrapment were used to secure its fascia.In the protracted period,strengthening the zheng,eliminating the pathogenic factors,and taking into account both specimens were utilized to repair the fascia.The characteristic treatment methods of softening the contracture and relieving the acute,protecting the ulceration and the membrane,and breaking down the underlying nest were proposed to provide a new idea for the treatment of CD in traditional Chinese medicine.