欲降先升理论治疗慢性便秘探讨

便秘在许多疾病的发生中起重要作用。其病位在大肠,与脾、胃、肝、肾、肺等脏腑的功能失调有关,基本病机为热结、气滞、寒凝、气血阴阳亏虚引起大肠传导功能失常。治疗时使用下法有一定效果,但易致诸多的不良反应。依据肺降肝升,肺与大肠相表里等整体观念提出欲降先升理论。强调胃肠气机不畅是便秘之本,肝气郁滞是便秘之因,肺气不宣是便秘之基;即欲使大便畅通下行,必先宣通肺气,疏肝解郁,在辨证论治的基础上,结合上窍开则下窍自通的理论,加用桔梗、杏仁、枳实、厚朴以起到下病治上、腑病治脏之功。

Approaching the Academic Thought of Rising First and then Descending on Chronic Constipation

Constipation plays an important role in a lot of diseases. Its ill location is in the large intestine, and concerned with the dysfunction of spleen, stomach, liver, kidney, lung and other organs. Its basic pathogenesis is heat knot, qi-stagnation, cold coagulation, and deficiency of yin and yang and qi and blood which caused large in- testine can not transport food. The method of purgation has a certain effect on them, but many adverse reactions are unavoidable. According to the theory of ＇ lung descending and liver rising＇ and＇ the lung and the large intestine being interior-exteriorly related＇this paper drew off the theory of＇ rising first and then descending＇. It underlines that the root of constipation is functional activity of qi being not smooth, the cause of constipation is depressed liver qi stagnation, the base of constipation is obstruction of pulmonary qi. If empting the bowels smoothly, we had to firstly open the inhibited lung qi and disperse the depressed liver qi. According to syndrome differentiation com- bined with the theory of ＇ upper orifices opening and lower orifices unobstructed automatically＇ , platycodon, apri- cot seed, immature orange fruit, and magnolia bark are applied in order to play the role of＇ lower disease to treat the upper, and hollow organs to cure solid organs＇.