附子理中汤“补火生土”治疗溃疡性结肠炎机制探讨

Discussion on Mechanism of Fuzi Lizhong Decoction(附子理中汤)“Nourishing Fire and Generating Earth”in Treating Ulcerative Colitis

溃疡性结肠炎(ulcerative colitis,UC)是以腹泻腹痛、黏液脓血便为主要特征的慢性肠炎,发病率呈逐年上升趋势,病变可累及结肠、直肠等部位,临床上具有难治愈、病程长、易复发等特点。临床中附子理中汤常联合西药、中医外治法等治疗脾肾阳虚型UC,现有大量实验研究和临床实践证实附子理中汤治疗脾肾阳虚型UC具有独特的优势。附子理中汤通过“补火生土”补肾阳滋脾土之阳实现“温补命门以培土,暖脾固肠而止泻”,以脾肾双补、温阳驱寒来治疗脾肾阳虚之证。且有相关实验及临床研究印证附子理中汤主要从抗炎镇痛、维持肠道免疫平衡、修复肠黏膜、调节肠道菌群、缓解氧化应激等方面治疗UC。该文将对附子理中汤“补火生土”治疗脾肾阳虚型UC的中医理论基础、作用机制以及临床研究进行系统论述,旨在为研究附子理中汤治疗UC提供进一步的理论依据以及实践参考。

Ulcerative colitis(UC)is a chronic enteritis characterised by diarrhoeal and abdominal pain,mucopurulent and bloody stools.Its incidence is increasing year by year.In clinical practice,Fuzi Lizhong Decoction(附子理中汤)is often combined with Western medicine and Chinese external treatment to treat the spleen and kidney Yang deficiency type of UC.A large number of experimental studies and clinical practice have confirmed the unique advantages of Fuzi Lizhong Decoction in treating spleen and kidney Yang deficiency type of UC.By nourishing fire and generating earth,Fuzi Lizhong Decoction tonifying the kidney Yang and nourishing the Yang of the spleen and earth,thus“warming the vital gate to cultivate earth,warming the spleen and consolidating the intestines to stop diarrhea”.It is used to treat signs of Yang deficiency in the spleen and kidney by tonifying both the spleen and kidney and warming Yang to expel cold.There are also relevant experimental and clinical studies confirming that the main aspects of the treatment of UC are anti-inflammatory and analgesic,maintenance of intestinal immune balance,repair ofintestinal mucosa,regulation of intestinal flora,and relief of oxidative stress. This paper will systematically discuss the theoretical basis of Chinese medicine,the mechanism of action and clinical research on the treatment of the spleen and kidney Yang deficiency type of UC by“tonifying fire and generating earth”with the use of Fuzi Lizhong Decoction. The aim is to provide a further theoretical basis as well as a practical reference for the study of the treatment of UC with Fuzi Lizhong Decoction.