从虚、热、湿、瘀、郁论治溃疡性结肠炎

Treating Ulcerative Colitis Based on the Pathogenesis of Deficiency,Heat,Dampness,Stasis,and Stagnation

溃疡性结肠炎病因较为复杂,常虚实夹杂、寒热错杂、多因素相互作用。本病病机关键在于虚、热、湿、瘀、郁,其中正虚为发病之本,其病理演变为气郁、热结、湿阻、血瘀,活动期主要病机为肠道湿热或肝脾不和,缓解期主要病机为脾虚湿蕴、脾肾阳虚或寒热错杂。临证遣方用药时首先辨析病情急缓及分期,再根据病情特点辨明病因病机、辨证分型,治以补益脾肾、平调寒热、清热化湿、活血化瘀、疏肝开郁。临床中应紧抓虚、热、湿、瘀、郁病机,辨证施治,灵活用药,方可收获疗效。

The etiology of ulcerative colitis(UC)is relatively complex,often involving a mixture of deficiency and excess,intermingling of cold and heat,and interactions of multiple factors.The key pathogenesis of UC lies in deficiency,heat,dampness,stasis,and stagnation,with deficiency being the root cause of the disease.The pathological progression involves qi stagnation,heat accumulation,dampness obstruction,and blood stasis.During the active phase,the primary pathogenesis is either intestinal damp-heat or disharmony between the liver and spleen.During the remission phase,the primary pathogenesis is spleen deficiency with dampness accumulation,deficiency of yang in both the spleen and kidney,or intermingling of cold and heat.When prescribing treatments,it is first necessary to analyze the urgency and stage of the condition,then identify the causes and mechanisms of the disease and classify the symptoms.Treatments include tonifying the spleen and kidney,balancing cold and heat,clearing heat and transforming dampness,activating blood circulation and resolving stasis,and relieving liver stagnation.In clinical practice,it is essential to closely grasp the pathogenesis of deficiency,heat,dampness,stasis,and stagnation,apply symptomatic treatments,and use medications flexibly to achieve therapeutic effects.