基于“肝苦急,急食甘药以缓之”理论论治干燥综合征

Theoretical Exertion and Application Examples of the Theory of “The Liver Qi Is in Hurry Station, Taking Sweet Medicine to Slow it Down” in Sj?gren’s Syndrome

干燥综合征是临床上较为常见的一种弥漫性结缔组织疾病,以眼干、口干、关节痛等为主要表现。传统中医认为干燥综合征的主要病机是燥邪侵犯,阴虚为本,燥热为标,燥邪蕴久成毒,脏腑功能失调。但部分观点认为在干燥综合征发病过程中既有津液绝对不足的一面,也有津液全身疏布障碍所致的津液相对不足的一面。肝气统领全身气机,在全身气血津液运行过程中发挥着重要作用,当肝失疏泻时津液难以畅达全身,导致体内津液相对不足。笔者将从“肝气苦急,急食甘药以缓之”的理论出发,探讨治疗干燥综合征时肝之气机的意义。“肝气苦急”即肝气容易因为各种原因导致气机不畅,经脉拘挛,肝气不畅则气血津液运行就不利,而生燥痹。因此治疗上侧重运用甘草、麦冬、茯苓、地黄等“甘味药”,缓解肝脉拘挛,调畅肝之气机,恢复肝之体用,从而缓解干燥综合征。

Sjögren’s syndrome is a relatively common clinical diffuse connective tissue disease, with dry eyes, dry mouth, and joint pain as the main manifestations. Traditional Chinese medicine believes that the main pathogenesis of Sjögren’s syndrome is the invasion of dryness pathogens, yin deficiency is the foundation, dryness and heat are the standard, dryness pathogens accumulate for a long time and become poisonous, and the viscera functions are dysfunctional. However, some viewpoints be-lieve that there is an absolute deficiency of body fluid in the pathogenesis of Sjögren’s syndrome, and there is also a relative deficiency of body fluid caused by the disorder of body fluid distribution. Liver qi dominates the whole body qi and plays an important role in the operation of qi, blood and body fluids in the whole body. This writer will start from the theory that “the liver qi is in hurry sta-tion, taking the sweet medicine urgently to slow it down”, and discuss the significance of the liver qi mechanism in the treatment of Sjögren’s syndrome. “Liver qi is bitter and urgent” means that liver qi is prone to stagnation of qi due to various reasons, and the meridians are constricted. Therefore, the treatment focuses on the use of “sweet herbs” such as licorice, Ophiopogon japonicus, Poria, Rehmannia glutinosa, etc., to relieve the constriction of the liver veins, regulate the qi mechanism of the liver, and restore the function of the liver, thereby relieving Sjögren’s syndrome.