张福利教授基于太阴–少阴理论治疗泄泻的经验

Professor Fuli Zhang’s Experience in Treating Diarrhea Based on the Theory of Taiyin-Shaoyin

摘要: 泄泻是消化系统的常见病，临床表现以排便次数增多、粪质稀薄、腹痛肠鸣，甚至泄出如水样为主症的病证。其归属于中医学“鹜溏”、“飧泻”、“下利”、“溏泄”、“濡泄”、“洞泄”、“肠澼”等范畴，可见于西医功能性疾病如肠易激综合征、功能性腹泻等。本病的发生与外邪、情志、饮食、体质、阳虚等相关，病机多为正虚邪实、湿邪困脾和肝旺克脾，病理因素多为湿邪、阳虚。张福利教授认为，脾虚湿盛为基本病机，阳虚和湿邪相兼致病。二者互为因果贯穿于疾病的始终。基于太阴–少阴理论，张福利教授结合多年临证经验提出了温阳健脾、祛湿、“顺势”的基本治则，自拟基础方，临证时，根据阳气偏衰或湿邪偏重的疾病不同阶段，加减方中诸药的温阳或祛湿之力，“观其脉证，随证治之”，获效颇丰。

Abstract: Diarrhea is a common disease of the digestive system, characterized by increased frequency of bowel movements, thin stool, abdominal pain, intestinal sounds, and even watery discharge. It belongs to the categories of traditional Chinese medicine, such as “wu tang”, “pi xie”, “xia li”, “tang xie”, “ru xie”, “dong xie”, and “chang yu”, and can be seen in functional diseases such as irritable bowel syndrome and functional diarrhea in Western medicine. The occurrence of this disease is related to external pathogens, emotions, diet, physical constitution, Yang deficiency, etc. The pathogenesis is mostly positive deficiency and pathogenic excess, with damp pathogens trapping the spleen and the liver acting on the spleen. Pathological factors should be noted as damp pathogens and Yang deficiency. Professor Fuli Zhang believes that spleen deficiency and excessive dampness are the basic pathological mechanisms, with both Yang deficiency and dampness pathogenic factors causing the disease. The two are mutually causal and run through the entire process of the disease. Based on the theory of Taiyin-Shaoyin, Professor Fuli Zhang proposed the basic treatment principles of warming Yang and strengthening spleen, dispelling dampness, and “following the trend” based on years of clinical experience. He self-formulated the basic formula, and during clinical practice, according to the different stages of diseases with weakened Yang Qi or excessive dampness, he adjusted the warming Yang or dispelling dampness power of various drugs in the formula, “observed the pulse syndrome, and treated it according to the syndrome”, achieving significant results.