基于肺胃肠理论探讨外感热病便秘病因病机

Discussion on the Etiology and Pathogenesis of Constipation Caused by Exogenous Fever Based on the Theory of Lung and Stomach

中医外感热病是以感受六淫、毒邪疠气为外因,以发热、口渴、大汗、乏力等为主要症状,是临床常见的急性传染性或感染性疾病。临证发现,外感热病患者除上述症状外,常伴有大便秘结的症状,倍增疾苦,变证丛生。中医学认为肺、胃、大肠经络相互络属,喜恶相近,生理病理协同,认为本病的发生以“肺-胃-大肠”传变为枢,总结其病理机制为邪气犯卫,肺病及肠;邪扰气乱,升降失调;热邪伤正,津亏气乏。基于此,笔者将其与现代医学发病机制的研究结合进行综述分析,具体从肺肠微生态、肺肠黏膜免疫,“肺-胃-肠”轴等现代医学角度分析肺胃肠理论的科学性,并总结外感热病便秘的治则为肠病治肺,肺肠同治;调畅气机,脾胃为要;清补润下,保津为枢,为外感热病便秘诊疗拓宽思路。

Objective The exogenous febrile disease of traditional Chinese medicine is a common acute infectious or infectious disease in clinic,which is caused by the external factors of six evils and toxic evils,and the main symptoms of fever,thirst,sweating and fatigue.In clinical practice,it is found that in addition to the above symptoms,patients with exogenous febrile diseases are often accompanied by symptoms of constipation,which doubles the pain and changes the syndrome.Traditional Chinese medicine believes that the lung,stomach and large intestine meridians are related to each other,likes and dislikes are similar,and physiology and pathology are coordinated.It is believed that the occurrence of this disease is transmitted to the'lung-stomach-large intestine'as the pivot,and its pathological mechanism is summarized as evil invading the defense,lung disease and intestine;evil disturbs qi,ascending and descending disorders;the heat evil hurts the body,and the body fluid is deficient.Based on this,the author will combine it with the research of modern medical pathogenesis to review and analyze,specifically from the perspective of modern medicine such as lung-intestinal microecology,lung-intestinal mucosal immunity,and'lung-stomach-gut'axis to analyze the scientific nature of lung-gastrointestinal theory,and summarize the treatment of constipation caused by exogenous febrile diseases.The treatment of lung is the treatment of intestinal diseases,and the treatment of lung and intestine is the same;regulating qi,spleen and stomach is important;under the Qingburun,Baojin is the pivot,which broadens the thinking for the diagnosis and treatment of exogenous fever constipation.