劳绍贤诊治便秘经验

LAO Shao-Xian’s Experience in Treating Constipation

介绍劳绍贤教授临床诊治便秘经验,并附验案3则以佐证。劳绍贤教授认为,便秘的病机为五脏功能失调,大肠传导失常。治疗上,以调理五脏、行气养阴为治则,并根据气虚、气滞、津伤的病机特点,病证结合,辨证施治。急性便秘者采用大承气汤或大黄牡丹汤治疗;慢性便秘者采用自拟润肠通便基础方(主要由槟榔、木香、台乌、郁李仁、生地黄、玄参、甘草等组成)治疗;其他胃肠疾病伴便秘者,治疗时可在胃病辨证用方基础上加用行气润肠药;大便多日未解者服用通便药前应先润化燥屎。同时嘱咐患者保持良好的饮食习惯,并进行腹部按摩、相关肌肉训练等以提高中药疗效,预防便秘复发。

This article introduces the clinical experience of Professor LAO Shao-Xian in the diagnosis and treatment of constipation,and three effective cases are attached to prove it.Professor LAO Shao-Xian believes that the pathogenesis of constipation is due to the dysfunction of the five viscera and the disorder of transportation in the large intestine.He emphasizes that the treatment of constipation should follow the principles of regulating the five viscera,promoting qi and nourishing yin,and should be based on disease-syndrome combination and syndrome differentiation according to the pathogenic characteristics of qi deficiency,qi stagnation and injury of body fluid.For acute constipation,Dachengqi Decoction or Dahuang Mudan Decoction are used;for chronic constipation,the self-made Basic Runchang Tongbian Recipe(mainly composed of Arecae Semen,Aucklandiae Radix,Linderae Radix,Pruni Semen,Rehmanniae Radix,Scrophulariae Radix,Glycyrrhizae Radix et Rhizoma,etc.)is used;for other gastro-intestinal disorders accompanied by constipation,qi-moving and intestinesmoistened medicines can be added on the basis of the recipe for gastric disorders.Measures for moistening the dry feces should be made for the patients failed in defecation for several days before taking medicines for promoting defecation.Moreover,patients are instructed to maintain good dietary habits and do abdominal massage and related muscle exercises by themselves to improve the efficacy of Chinese medicine and prevent the recurrence of constipation.