基于“异病同治”理论探讨消化道溃疡寒热并用治法的理论浅析

Theoretical Analysis of the Combined Use of Cold and Heat in the Treatment of Peptic Ulcer Based on the Theory of “Treating Different Diseases with the Same Method”

摘要: 消化道溃疡作为临床常见复发性疾病，以复发性口腔溃疡、胃溃疡、溃疡性结肠炎等为常见症状，其迁延难愈的特征对现代医学提出了挑战。现代医学治疗多使用免疫抑制剂、抗炎药等缓解疾病症状，但长期效果不佳。与西医治疗相比，中医药在治疗消化道溃疡中有着独特的理论基础和丰富的临床经验，在减少溃疡生成方面疗效显著。“异病同治”是中医辨证论治的重要体现，消化道溃疡虽在病变部位、临床表现上有所差异，但其核心病机均为寒热错杂，因此可“异病同治”。“寒热并用”法以调和寒热、平衡阴阳为长，是“异病同治”治理消化道溃疡的关键。基于“异病同治”理论，文章系统探讨了上述疾病的共性病机及核心治疗方法，并以寒热并用经典名方为例，阐述其通过调和脾胃、平衡阴阳实现“异病同治”的理论依据，为消化道溃疡的中医精准治疗提供理论支撑。

Abstract: Gastrointestinal ulcers, as a common recurrent clinical condition, manifest primarily as recurrent oral ulcers, gastric ulcers, and ulcerative colitis. Their protracted and difficult-to-heal nature poses challenges to modern medicine. Modern medical treatments primarily employ immunosuppressants and anti-inflammatory drugs to alleviate symptoms, yet long-term efficacy remains suboptimal. Compared with Western medicine, Traditional Chinese Medicine has a unique theoretical foundation and extensive clinical experience treating gastrointestinal ulcers, demonstrating significant efficacy in reducing ulcer formation. The principle of “treating different diseases with the same method” embodies the essence of TCM pattern differentiation and treatment. Although digestive tract ulcers vary in location and clinical presentation, their core pathogenesis involves the interplay of cold and heat, which justifies this unified approach. The “combining cold and heat” method excels at harmonizing cold and heat while balancing yin and yang, serving as the cornerstone of this unified treatment strategy for digestive tract ulcers. Based on the theory of “treating different diseases with the same approach,” this paper systematically explores the common pathogenic mechanisms and core therapeutic methods for the aforementioned diseases. Using classic formulas for treating cold and heat simultaneously as examples, it elucidates the theoretical basis for achieving “treating different diseases with the same approach” through harmonizing the spleen and stomach and balancing yin and yang, providing theoretical support for the precise treatment of digestive tract ulcers with TCM.