摘要
[目的]总结李新民教授基于运脾学说治疗儿童功能性便秘的学术经验。[方法]通过跟师学习、阅读古籍、整理临床医案,阐述运脾学说的理论渊源,分析李师从“运脾”角度探讨儿童功能性便秘的病因病机,以及运用运脾理论治疗儿童功能性便秘的临床经验,并附验案加以佐证。[结果]李师认为儿童功能性便秘的病因主要为饮食积滞致损伤脾胃,病机关键为“燥粪内结为标,大肠传导失司;脾胃虚损为本,脏腑气机失衡”,其中尤以脾胃、肝肺枢机升降失调为主。基于“运脾”思想及“三因制宜”指导原则,临床采用“健脾培本,寓补于运;斡旋枢机,诸法结合”的治疗手段,形成以“疏运斡旋”为特点的运脾调枢法,自拟运脾方培补脾土,重在升运脾阳、斡旋中焦、调理气机。临证根据兼证灵活配合消导、清热、通下、益气等诸法,善用和法调和寒热虚实,强调药贵和平,避免过伐伤正。所附验案属脾虚失健、枢机不畅、食滞内停,治以运脾和胃、调畅气机、导滞通便,自拟运脾方化裁。[结论]李师基于“运脾学说”,运用以疏运斡旋为特色的运脾调枢法,理论独特,为临床提供新思路与方法,值得推广学习。
[Objective]To summarize Professor LI Xinmin’s clinical experience in treating functional constipation in children based on the theory of spleen movement.[Methods]Through learning from the teacher,reading ancient medical books and sorting out clinical medical cases,this paper expounds the theoretical origin of the spleen-transportation theory,analyzes Professor LI’s exploration of the etiology and pathogenesis of functional constipation in children from the perspective of“spleen transportation”,as well as the clinical experience in treating children’s functional constipation with the spleen-transportation theory,and attaches a verified case for evidence.[Results]Professor LI holds that the main etiology of functional constipation in children is the damage to the spleen and stomach caused by dietary stagnation.The key pathogenesis is characterized by“dry fecal accumulation being the secondary aspect with dysfunction of large intestine conduction,and spleen-stomach deficiency being the primary aspect with disharmony of Qi movement in internal organs”,among which the disorder of ascending-descending mechanisms in the spleen-stomach and liver-lung axis is particularly prominent.Guided by the“spleen-transportation”theory and the principle of“three-adaptation therapy”,clinical treatment employs the strategies of“strengthening the spleen for root cultivation with tonification in transportation,regulating pivotal mechanisms through combined therapies”,forming the spleen-transporting pivot-regulation method featured by“dredging-transportation and pivot-regulation”.The self-formulated Yunpi Decoction is used to invigorate spleen-earth,focusing on ascending spleen-Yang,regulating middle-Jiao,and regulating Qi movement.In clinical practice,therapies like digestion-promoting,heat-clearing,purging and Qi-supplementing are flexibly integrated based on concomitant syndromes.The harmony method is adeptly applied to reconcile cold-heat and deficiency-excess,emphasizing that medications should be mild to avoid excessive purgation from damaging vital Qi.The pathogenesis of the attached case belonged to spleen deficiency and lack of health,with poor pivot function and internal food stagnation.The treatment adopted the methods of invigorating the spleen and stomach,regulating Qi and promoting smoothness,guiding stagnation and relieving constipation,and administered with the self-designed modified Yunpi Decoction.[Conclusion]Based on the“spleen-transportation theory”,Professor LI applies the spleen-transportation and pivot-regulation method featuring dredging-transportation and pivot-regulation.With its unique theory,this approach provides new ideas and methods for clinical practice,making it worthy of promotion and learning.
作者
陈鸿祥
李新民
韩耀巍
秦潞平
CHEN Hong xiang;LI Xinmin;HAN Yaowei(First Teaching Hospital of Tianjin University of Traditional Chinese Medi-cine,National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion,Tianjin(300381),China)
出处
《浙江中医药大学学报》
2025年第8期1040-1043,共4页
Journal of Zhejiang Chinese Medical University
基金
天津市名中医传承工作室建设项目(879022)。
关键词
儿童功能性便秘
运脾学说
运脾调枢法
自拟运脾方
三因制宜
医案
临床经验
李新民
functional constipation in children
the theory of spleen transporting function
the method of regulating the spleen transportation and pivot of Qi movement
self-formulated Yunpi Decoction
three causes adaptation principle
medical records
clinical experience
LI Xinmin
