运脾和胃调肝法治疗小儿脾胃病临证经验

目的]探析运脾和胃调肝法治疗小儿脾胃病经验。方法]从小儿脾胃生理、病理特点、病因病机、治疗方法等方面总结用运脾和胃调肝法治疗小儿脾胃病的学术观点和临床经验,并附验案佐证。结果]小儿脾胃具有生理上"脾常不足",病理上易虚易实、易寒易热的特点。脾胃疾病多由饮食喂养不当、先天不足或久病重病损伤等所致,脾失健运、脾气困惫、脾湿胃燥、脾升胃降、脾化胃纳等功能失调是其主要病机,若脾胃受损,可衍生多种相关疾病。在临床中将此治疗大法归纳为运脾和胃调肝,并可进一步细分为运脾、健脾、补脾、疏肝、柔肝、泻肝、和胃、清胃、降逆等诸多治法,可应用于小儿厌食症、再发性腹痛、泄泻、便秘等疾病的治疗中,并获得验证。结论]运脾和胃调肝法是治疗小儿时期脾胃疾病的有效方法。

Clinical Experience in Treating Pediatric Spleen-stomach Diseases with the Therapy of Spleen-activating, Stomach-harmonizing and Liver-regulating

Objective] To explore and analyze the experience of activating spleen, harmonizing stomach and regulating liver in treating pediatric spleen-stomach diseases.Method] We summed up the academic viewpoints and clinical experiences of using the method of activating spleen, harmonizing stomach and regulating liver for treating pediatric spleen-stomach diseases, from the aspects of physiological and pathological characteristics, etiology and pathogenesis, treatments ,and attached with medical records.Results] According to the feature of infantile physiology and pathology, spleen and stomach are frequently insufficient, suffering deficiency or excess and cold or heat easily, most of the spleen-stomach diseases are caused by improper feeding, congenital deficiency or chronic disease. Dysfunction of spleen in transportation, spleen Qi deficiency and the disharmony of spleen damp and stomach dryness, spleen up-bearing and stomach down-bearing, spleen governing transformation and stomach governing reception are the main pathomechanism of the disease. If spleen and stomach are damaged, a variety of related diseases can be derived. In clinic, the treatments of this kind of disease are classified as activating spleen, harmonizing stomach and regulating liver. It can be further subdivided into many treatments, such as activating spleen, fortifying spleen, tonifying spleen, soothing liver, emolliating liver, purging liver, harmonizing stomach, clearing stomach, descending adverse Qi. These therapies have been used to treat anorexia, recurrent abdominal pain, diarrhea, constipation and other diseases, and obtaine very good results.Conclusion]Activating spleen, harmonizing stomach and regulating liver is an efficient treatment for pediatric spleen-stomach diseases.