从《四圣心源》“一气周流”学说论析辨治腹泻型肠易激综合征

Analysis and Treatment of Diarrhea-Predominant Irritable Bowel Syndrome Based on the “One Qi Circulation” Theory from The Heart Source of the Four Sages

摘要: “一气周流”理论是清代医学家黄元御《四圣心源》的思想精华，对指导临床治疗腹泻型肠易激综合征有重要意义。中土湿盛导致的斡旋功能失调和升降清浊不分是腹泻型肠易激综合征的根本病机。同时，肾水寒土溃火败、肝木郁土气壅滞、肺金宣肃不畅以及大肠传导失职等因素，也是该病发生和发展的重要环节。在“一气周流”理论的指导下，治疗腹泻型肠易激综合征需从整体上把握人体气机的运行，特别强调中土的斡旋功能和脏腑气机的演变。治疗方法包括健脾祛湿、温肾健脾、疏肝理脾和温肺益气等，旨在促进“一气周流”，从而为临床治疗腹泻型肠易激综合征提供了新的思路和方法。

Abstract: The “One Qi Circulation” theory, the quintessence of thought from Huang Yuanyu’s The Heart Source of the Four Sages during the Qing Dynasty, holds significant importance for guiding the clinical treatment of diarrhea-predominant Irritable Bowel Syndrome (IBS-D). The fundamental pathogenesis of IBS-D is attributed to the dysfunction of the central earth’s regulatory role due to excessive dampness and the failure to distinguish between clear and turbid elements in the processes of ascending and descending. Concurrently, the failure of the fire due to cold water in the kidneys, the congestion of earth qi due to the stagnation of liver wood, the impaired announcement and descent of lung qi, and the dereliction of duty in the large intestine’s conduction are also crucial factors in the occurrence and progression of the disease. Guided by the “One Qi Circulation” theory, the treatment of IBS-D requires a holistic approach to the regulation of the body’s qi dynamics, with a particular focus on the central earth’s regulatory function and the transformation of the viscera’s qi mechanisms. Therapeutic approaches include strengthening the spleen to eliminate dampness, warming the kidneys to strengthen the spleen, soothing the liver to regulate the spleen, and warming the lungs to boost qi, all aimed at facilitating “One Qi Circulation”. This offers new perspectives and methodologies for the clinical management of diarrhea-predominant irritable bowel syndrome.