益气升清法在治疗肝硬变腹水中的应用

肝硬变腹水病机乃本虚标实,治疗当强调扶正补虚,脾胃位居中焦,乃气机升降之枢,故需强调健脾益气以扶正气,升提清阳以降湿浊从而增强中医辨治肝硬变腹水的疗效。肝硬变腹水其标总以水湿为患,但气能行水,故有形之水湿,必依赖于无形之气的推动方不停聚为邪,故治水必治气,气足则水行。不论在肝硬变腹水的早期或晚期,不论是邪实为甚还是正虚为主,益气升清法需贯穿治疗的全过程,在早期可"见肝之病,知肝传脾,当先实脾"而达厚土制水以防腹水生成,在晚期可益气培土升清以助腹水消散及防止复发。

The Application of Tonifying Qi and Ascending Clear Qi Method in Treating Ascites of Liver Cirrhosis

The pathogenesis of ascites of liver cirrhosis is asthenia in origin and sthenia in superficiality,so the treatment emphasizes strengthening genuine qi and nourishing deficiency.The spleen and stomach lie in the middle energizer,a key position for ascending and descending of qi activity,so invigorating spleen and replenishing qi should be emphasized to strengthen genuine qi,ascending clear qi and descending turbidity to enhance the curative effect of TCM in treating cirrhosis ascites.The superficiality of ascites of cirrhosis is excessive water dampness,but qi can drive water,so visible water dampness must depend on the invisible gas to avoid dampness accumulation,so removing water retention must first regulating qi,because sufficient qi can guide water movement.Tonifying qi and ascending clear qi method should run through the whole course of treatment of liver cirrhosis,whether in the early or late stage of liver cirrhosis ascites,whether the etiology is excessive pathogenic factor or deficient genuine qi.In the early stage,invigorating spleen can avoid formation of ascites;while in later stage,tonifying qi and invigorating spleen and ascending clear qi method can be adopted to disperse ascites and avoid recurrence.