摘要
现代学者对久泄(泻)的范畴、病因病机皆有探讨,病因分为外感风寒、内伤饮食及情志、失治误治、其他疾病所致四类,脾胃运化功能不健,肠腑传导化物失职是本病病机的重点,病变涉及肾、肝、肺、心四脏;在辨证论治方面,以脏腑辨证为主,根据病变所涉及的脏腑数量的不同,分为一脏为病、两脏为病、三脏为病;此外,尚有病性辨证,分别为辨气血证候、辨六淫证候、辨津液证候。由于对同一证型,医家对具体症状的认识存在差异,所以需要分别列出;最后,对当前久泄(泻)研究中存在的问题进行了简要总结,问题主要包括:①不同学者对同一证型下的症状记述存在差异,那么我们该怎么确定某证型的症状,又该如何认识和处理这些差异。②同一证型,医家所用的方药有时不同,方药的不同对应的症状也存在差异,这种方药的不同和症状差异之间是否存在关联性,如果存在关联,如何解释这种关联性。③我们可运用现代医学的诊查手段对久泄(泻)的具体病变位置和内部病变情形进行深入细致的观察,但我们该如何用中医的思想和术语表达这一观察结果,并将之和辨证论治结合在一起。如果学者能对这些问题进行恰当的处理和解决,久泄(泻)诊治的标准化或可逐步被建立。
Until now the category,cause and pathogenesis of chronic diarrhea have been discussed.Affection of exogenous windcold,improper diet,emotional disorder,lacking of proper treatment or mistreatment,caused by other diseases are the main reasons ofchronic diarrhea.The basic pathogenesis of the chronic diarrhea lies in the dysfunction of stomach,small intestine and large intestine.Dysfunction of liver,kidney,lung and heart are also involved in the pathological changes of chronic diarrhea.On syndrome differentiationand treatment administration,researches refer more to differentiation of zang-fu viscera,dysfunction of one,two or three of the five visceraleading to chronic diarrhea.Besides,there are other types of syndrome differentiation.Based on the Qi and blood,six exogenous pathogenicfactors,and body fluid,chronic diarrhea could be differentiated to different patterns.The specific symptoms must to be listed separatelyfor different cognitions on the specific symptoms of the same syndrome.The problems existing in the current research of chronic diarrheaare inferred as below after the summarization:①Different understanding to the same syndrome pattern.Which should be the best suitableor accurate one for the standard of symptom differentiation of chronic diarrhea?How to understand and deal with these differences?②Different prescription to the same syndrome pattern.Is there a correlation between the different prescription and different symptom?How to explain it if it exists?③The specific location of lesions of chronic diarrhea and the pathological changes can be investigated bymodern instruments and examination,but how the result can be explained by traditional Chinese medical terms,and how can it be combinedwith the syndrome differentiation and treatment administration?The TCM standard of diagnosis and treatment of chronic diarrhea will beset up as these problems been solved properly step by step.
出处
《中医临床研究》
2017年第12期38-40,共3页
Clinical Journal Of Chinese Medicine
关键词
久泄(泻)
辨证论治
Chronic diarrhea
Syndrome differentiation and treatment
