文章摘要
方誉澄,储浩然,王子叶,等.基于“升清-理中-培元”的腹泻型肠易激综合征诊治思路探讨[J].浙江中医药大学学报,2024,48(6):695-698.
基于“升清-理中-培元”的腹泻型肠易激综合征诊治思路探讨
Exploring the Thinking of Diarrhea Type Irritable Bowel Syndrome Based on“Ascending Qi Mechanism,Regulating the Middle-Jiao,and Nourishing Vital Energy”
DOI:10.16466/j.issn1005-5509.2024.06.009
中文关键词: 腹泻型肠易激综合征  升清气机  调理中焦  培补元气  针灸  穴位  验案  储浩然
英文关键词: diarrhea type irritable bowel syndrome  ascending Qi mechanism  regulating the middle-Jiao  nourishing vital energy  acupuncture and moxibustion  acupoint  medical cases  CHU Haoran
基金项目:国家自然科学基金面上项目(81774399);储浩然全国名老中医药专家传承工作室(国中医药人教函﹝2022﹞75号);安徽省重点研究与开发计划项目(202204295107020046)
作者单位
方誉澄 安徽中医药大学合肥 230031 
储浩然 安徽中医药大学第二附属医院
安徽省中医药科学院针灸临床研究所
安徽省针灸临床医学研究中心 
王子叶 安徽中医药大学合肥 230031 
朱敬伟 安徽中医药大学合肥 230031 
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中文摘要:
      [目的] 总结储浩然教授对腹泻型肠易激综合征的认识及治疗经验。[方法] 通过临床跟师学习,查阅古籍并结合现代文献研究,总结储师对腹泻型肠易激综合征的认识及治疗思路,明确该疾病基本诊治规律,并举临床医案一则加以佐证。[结果] 储师认为,中焦气机失调是腹泻型肠易激综合征的核心病机,主张以“升清气机-调理中焦-培补元气”为治疗思路,以天枢穴为核心穴位,配以中脘、章门、上巨虚、大肠俞、足三里调理中焦脾胃,配以龙虎交战的针刺手法,助中焦气机畅达。重点选用“百会-内关”调节清气,梳利头脑心神,提升整体气机,此外以“关元-足三里”固本培元,培补先天元气。验案中患者中医辨证为脾胃虚弱证,兼有心神不宁、阳气虚衰之象,储师以升清-理中-培元法治之,补后天以滋先天,并予以安神,收效显著。[结论] 储师临床上根据辨证,增减穴位,通过整合穴位群,使中焦气机升降有利,形成了独具特色的“调中复元”的腹泻型肠易激综合征诊疗体系,为腹泻型肠易激综合征的临床治疗提供了新思路。
英文摘要:
      [OObbjjeeccttiivvee] To summarize Professor CHU Haoran’s understanding and treatment experience on diarrhea type irritable bowelsyndrome(IBS-D). [MMeetthhooddss] Through clinical study with teachers,consulting ancient books and combining modern literature research, summarize the understanding and treatment ideas of Professor CHU for IBS-D,clarify the basic diagnosis and treatment rules of the disease,and provide a clinical medical case as evidence. [RReessuullttss] Professor CHU believes that disordered movement of Qi in the middle-Jiao is the core pathomechanism of IBS-D. He advocates for the treatment principle of“ascending Qi mechanism,regulating the middle-Jiao,and nourishing vital energy”The acupoint Tianshu(ST25) is considered the focal point,complemented by Zhongwan(CV12), Zhangmen(LR13),Shangjuxu(ST37),.Dachangshu(BL25),and Zusanli(ST36) to regulating the middle-Jiao. This is paired with the needling technique of“Dragon and Tiger battle”to assist in facilitating the flow of Qi in the middle-Jiao. A key selection is“Baihui (DU20)-Neiguan(PC6)”to regulate the clear Qi,comb the mind and spirit located in the head,and elevate the overall movement of Qi. Additionally,“Guanyuan(RN4)-Zusanli(ST36)”are used to firm the foundation and cultivate the primal Qi,supplementing the innate vital energy. In a case study,the patient was diagnosed with syndrome differentiation of spleen and stomach deficiency,with concurrent restlessness of the heart spirit and signs of deficient Yang Qi. Professor CHU treated the patient by using the method of raising the clear Qi, managing the middle-Jiao,and nourishing vital energy,supplementing the postnatal to nourish the prenatal while calming the spirit, resulting in significant effects. [CCoonncclluussiioonn] In clinical practice,Professor CHU modifies acupoints according to syndrome differentiation. By integrating groups of acupoints,he facilitates the beneficial ascent and descent of Qi within the middle-Jiao,creating a distinctive “regulating the middle and restoring the vital energy”diagnostic and treatment system for IBS-D,which provides a new approach to the
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