腹泻型肠易激综合征病因病机及脏腑论治

Etiology,Pathogenesis and Visceral Treatment of Diarrhea-predominant Irritable Bowel Syndrome

腹泻型肠易激综合征(diarrhea-predominant irritable bowel syndrome,IBS-D)是一种临床常见的功能性胃肠疾病,因其发病机制尚未被完全阐明,故针对性的干预措施尚有一定局限。且该病具有症状反复的特点,严重影响了患者的生活质量。中医学对IBS-D有着独特的认识,以“辨证论治”等为理论指导具有显著的思维优势,而明其因、知其理是辨证论治的关键前提,故系统阐述其发病机制至关重要。因此从中医角度对IBS-D病因病机进行概括总结,认为其病因病机主要与体质禀赋易感、外感六淫时邪、饮食不节伤脾、脏腑功能失调等因素有关。并在辨证论治的理论指导下,以脾虚为共性基础,强调五脏相关理论和整体观念,来科学、合理辨析该病的病因、病机、病位、病势,以期为进一步提高临床疗效提供理论支撑。

Diarrhea-predominant irritable bowel syndrome(IBS-D)is a clinically common functional gastrointestinal disorder,the pathogenesis of which has not been completely elucidated,and therefore the targeted interventions are still limited.The disease is characterized by recurrent symptoms and persistence,which seriously affects the normal work and life of patients.Chinese medicine has a unique understanding of IBS-D and has significant advantages in the theoretical guidance of“dialectical treatment”,and understanding the cause and reason is the key premise of dialectical treatment,so it is important to systematically elaborate its pathogenesis.Therefore,this paper summarizes the etiology and pathogenesis of IBS-D from the perspective of Chinese medicine,and concludes that the etiology and pathogenesis of IBS-D are mainly related to the physical endowment,susceptibility to external infection with the six evil spirits,injury to the spleen by uncontrolled diet,and dysfunction of the internal organs.Under the guidance of the theory of evidence-based treatment,the common basis of spleen deficiency and the related theory of the five organs and the overall concept were emphasized to scientifically and rationally identify the etiology,pathogenesis,location and potential of the disease,in order to provide theoretical support for further improvement of clinical efficacy.