董明国采用运脾扶阳、祛湿止泻法治疗溃疡性结肠炎经验

Experience of DONG Ming-Guo in Treating Ulcerative Colitis with the Method of Activating Spleen to Support Yang and Dispelling Dampness to Arrest Diarrhea

介绍董明国教授治疗溃疡性结肠炎的经验。董明国教授认为,溃疡性结肠炎的病位在肠,与脾、胃、肝、肾等脏腑亦密切相关,其发病多涉及肝气郁结、脾虚湿盛、肾虚火衰这3个环节。脾虚湿困为溃疡性结肠炎的根本病机,治法以运脾扶阳、祛湿止泻为主,自拟溃结方加减以治疗本病。溃结方的药物组成为白术、熟附子、煨葛根、干姜、砂仁、枳壳、白扁豆、车前子、乌梅、秦皮、马齿苋、石榴皮、炙甘草、焦山楂、炒麦芽。对于溃疡性结肠炎活动期单纯服用中药效果不佳的患者,可配合中药灌肠治疗。中药灌肠方由青黛、败酱草、救必应、蚕砂、地榆炭、黄芪、毛冬青组成。溃疡性结肠炎患者病程长,症状反复,多虚中夹实,亦有兼寒兼热,用药需根据实际情况,分清标本虚实,侧重用之,抓住病因,以取显效。

This article introduced Professor DONG Ming-Guo's experience in treating ulcerative colitis.Professor DONG believes that ulcerative colitis involves the intestines and is also closely related to the spleen,stomach,liver and kidney,and its pathogenesis mostly covers the three steps of liver qi stagnation,spleen deficiency with predominant dampness,and decline of fire due to kidney deficiency.Spleen deficiency leading to dampness encumbrance is the fundamental pathogenesis of ulcerative colitis and its primary treatment is through the methods of activating spleen to support yang,and dispelling dampness to arrest diarrhea.The self-made recipe of modified Kuijie Recipe was proposed to treat ulcerative colitis.Kuijie Recipe is composed of Atractylodis Macrocephalae Rhizoma,Aconiti Lateralis Radix Praeparata,roasted Puerariae Lobatae Radix,Zingiberis Rhizoma,Amomi Fructus,Aurantii Fructus,Lablab Semen Album,Plantaginis Semen,Mume Fructus,Fraxini Cortex,Portulacae Herba,Granati Pericarpium,Glycyrrhizae Radix et Rhizoma Praeparata cum Melle,charred Crataegi Fructus,and fried Hordei Fructus Germinatus.For patients with active ulcerative colitis who are not effective after treatment with oral use of Chinese herbs alone,Chinese medicine enema can be used for assistance.The Chinese medicine enema prescription consists of Indigo Naturalis,Patriniae Herba,Ilicis Rotundae Cortex,Feculae Bombycis,charred Sanguisorbae Radix,Astragali Radix,and Ilex Pubescens Radix.For the patients with ulcerative colitis have a long duration of illness and recurring symptoms,their pathogenesis mostly is due to deficiency interweaved with excess and the concurrence of cold and heat.The medication for ulcerative colitis should be performed in accordance with the actual situation to distinguish between the symptom and root cause,to identify the deficiency or the excess,and to focus on the etiology of the disease in order to achieve significant results.