基于“态靶辨证”理论探析举元煎加味对脾虚气陷型痔术后肛门坠胀的治疗作用

Analysis of the Therapeutic Effect of Modified Juyuan Decoction on Anal Distention after Hemorrhoidal Surgery with Spleen Deficiency and Qi Depression Based on the Theory of“State-target Differentiation”

肛门坠胀是痔术后常见并发症之一,严重影响痔术后患者创面愈合情况。基于仝小林院士“态靶辨证”学术思想,临床观察到痔术后患者出现肛门坠胀时,多属于“虚”态,多辨为“脾虚气陷证”。现结合多年临床经验,观察发现应用举元煎补中益气、升阳举陷,可以调节“脾虚气陷”证之虚态。延胡索行气活血止痛,以“气络”为靶,贯通气血,理气通络;当归补血活血,以“血络”为靶,化瘀生新;黄柏清热燥湿、解毒疗疮,以“湿络”为靶,清下焦湿热,三药共打瘀滞湿热之靶。态靶结合,效如桴鼓,能有效改善患者肛门坠胀症状,提高痔术后创面愈合情况。

Anal distention is one of the common complications after hemorrhoidal surgery,which seriously affects the wound healing of patients after hemorrhoidal surgery.Based on Academician Tong Xiaolin s academic thought of“state-target differentiation”,it has been clinically observed that when the anus bulge occurs in patients after hemorrhoidal surgery,most of them belong to the“vacuity”state and are often distinguished as“spleen deficiency and qi depression syndrome”.Combining with many years of clinical experience,it is found that modified Juyuan Decoction is applied to tonify spleen-stomach to invigorate qi,promote yang to raise depression,and can regulate the deficiency state of“spleen deficiency and qi depression”syndrome.Corydalis yanhusuo is used to promote qi and activate blood to relieve pain,with“qi collaterals”as the target,penetrating qi and blood and regulating qi and clearing collaterals.Angelica is to tonify blood to promote blood circulation,with“blood collaterals”as the target,removing stasis and generating new life.Phellodendron is to clear heat and to dry dampness,detoxify and cure sores,with“wet collaterals”as the target,clearing dampness and heat of lower abdomen.The three herbs are aimed to the target of stasis and dampness and heat.The combination of the state-target is like drumstick and drum that can effectively improve the anus swelling symptoms,and accelerate the wound healing after hemorrhoidal surgery of patients.