肠痈源流考

Investigation on Origin and Development of Intestinal Carbuncle

通过对历代医籍中关于肠痈的论述进行整合,考释肠痈病的源流,分析“肠痈”在不同历史时期的表达特点,以及历代医家对肠痈认识的发展,清其脉络,溯其本源。肠痈发病急骤,以腹部疼痛为主要特点,纵览历代医家对肠痈病因病机之论述,虽颇为复杂,然不出内外两因,内因由饮食偏嗜壅阻肠道,情志所伤、脏器郁结等因素导致气血瘀阻,以致肠道失养受累发为肠痈;外因则寒热失调、客于肠中,湿热郁阻、瘀滞经络等邪气侵扰,血气蕴结发为肠痈。临床论治应从整体出发,分清标本缓急:初起脓未成者,当行以去壅之消法;脓已成或溃后脓出不畅者,行以疏通痈滞、调理气血之托法;脓未成或痈脓破溃后期者,行以固本生肌之补法,并剖析了消痈散结的灸法、脱腐新生的切开排脓法等外治法,以期为肠痈的研究及临床治疗提供理论基础和参考。

This paper integrates the related disease and syndrome discussion of intestinal carbuncle in the important medical books of the past dynasties,examines the origin of intestinal carbuncle disease,analyzes the expression characteristics of "intestinal carbuncle" in different historical periods,as well as the development of doctors' understanding of intestinal carbuncle in the past dynasties,clears its context,and traces its origin.Intestinal carbuncle is characterized by acute onset and abdominal pain.Its clinical manifestations are variable.It should be treated as early as possible.If it is delayed for a long time,it may cause other diseases.Therefore,it is classified and named as the main disease of intestinal carbuncle and severe intestinal carbuncle.Looking at the discussion on the etiology and pathogenesis of intestinal carbuncle by doctors in previous dynasties,although it is quite complex,there are internal and external causes.The internal causes are caused by diet preference,intestinal obstruction,emotional injury,organ depression and other factors,which disturb the qi,block the blood vessels,and damage the liver organs,so that the intestinal tract is dystrophic and involved,which is called intestinal carbuncle;external causes are cold and heat disorders,deposit in the intestine,damp and heat stagnation,stagnation of meridians and other evil gases invade the blood gas accumulation,and the formation of intestinal carbuncle.Clinical treatment should start from the whole,and distinguish the urgency of the specimen:those who have not completed the purulence at the beginning should be treated by removing the obstruction;if the pus has become or the pus does not flow smoothly after ulceration,use the support method of dredging carbuncle stagnation and regulating qi and blood;for those who have not formed pus or in the late stage of carbuncle pus rupture,the method of strengthening the body and generating muscle should be used,and the external treatment methods such as moxibustion for eliminating carbuncle and dispersing knot,incision and purulent discharge method for removing corruption and regeneration,in order to provide theoretical basis and reference for the research and clinical treatment of intestinal carbuncle.