基于健脾利湿理论的五苓散治疗泄泻作用机制及临床应用探析

An Analysis of the Mechanism and Clinical Application of Wuling San in Treating Diarrhea Based on the Theory of Invigorating the Spleen for Eliminating Damping

摘要: 泄泻是以排便次数增多、粪质稀溏为主要表现的常见病证，其病机关键责之于脾失健运、湿浊内生。五苓散作为张仲景所创经典名方，具有利水渗湿、温阳化气之功，后世医家基于“利小便以实大便”的理论，将其广泛应用于泄泻的治疗。本文系统梳理了泄泻的病因病机，深入分析了五苓散的组方配伍及其健脾利湿的核心作用机制。通过回顾历代医家应用与拓展，结合现代药理学研究，论证了五苓散治疗泄泻的科学性和有效性，并附医案一则佐证。

Abstract: Diarrhea, a common clinical syndrome, is characterized by increased frequency of defecation and loose stools. Its core pathogenesis lies in the dysfunction of the spleen in transport and endogenous turbid dampness. Wuling San, a classical prescription originated by Zhang Zhongjing, functions to eliminate dampness and diuresis, warm yang to transform qi. Guided by the therapeutic principle of “Treating Diarrhea by Promoting Urination”, physicians throughout history have extensively applied it to treat diarrhea. This paper systematically elucidates the etiology and pathogenesis of diarrhea and provides an in-depth analysis of the herbal composition and the core mechanism of Wuling San in strengthening the spleen and eliminating dampness. By reviewing its historical applications and expansions, integrated with modern pharmacological research, this study demonstrates the scientific basis and efficacy of Wuling San for diarrhea, which is further corroborated by an attached clinical case study.