基于“相火在位”理论探讨藏肾疏肝法治疗溃疡性结肠炎

Discussion of treatmenting ulcerative colitis by the method of sealing the kidney and dispersing the liver based on “ministerial fire in position” theory

溃疡性结肠炎属于炎症性肠病,其发病机制与肠道免疫紊乱相关。近年来有学者根据相火生理病理特点提出“相火免疫”学说。通过梳理“相火在位”的理论内涵,认为相火在位与肾精封藏、肝气疏泄具有生理相关性,结合溃疡性结肠炎临床症状及病理基础,认为“肾失封藏、相火妄动”是溃疡性结肠炎发病的根本病机,并提出藏肾疏肝的治疗大法,以填补下焦,封髓藏肾固其根本,配合清遏余邪、疏肝敛阳以治其标,分予清热疏肝、利湿化浊、散瘀解毒以“消、敛、降”妄火,标本兼治,为中医辨治溃疡性结肠炎提供新思路。

Ulcerative colitis is an inflammatory bowel disease,and its pathogenesis is related to intestinal immune disorders.In recent years,some scholars have proposed the theory of “ministerial fire immunity” based on the physiopathological characteristics of ministerial fire.In this paper,by sorting out the theoretical connotation of “ministerial fire in position”,we believe that ministerial fire in position is physiologically related to kidney essence sealing and liver controlling dispersion,and combined with the clinical symptoms and pathological basis of ulcerative colitis,we believe that “loss of kidney sealing and hyperactivity of ministerial fire” is the fundamental pathogenesis of ulcerative colitis.We proposed the treatment method of sealing the kidney and dispersing the liver,seal the marrow and hide the kidney to consolidate its root,together with clearing and suppressing residual evil,dredging the liver and regulating yang to treat its symptoms,and dividing heat and dispersing the liver,relieving dampness and removing turbidity,dispersing blood stasis and detoxifying the delusional fire to “eliminate,converge and lower” the frenetic fire,providing new ideas for the identification and treatment of ulcerative colitis in Chinese medicine.