談腸躁症的中醫治療

Traditional Chinese Medical Therapy upon Irritable Bowel Syndrome

林文彬(Wen-Pin Lin)

《北台灣中醫醫學雜誌》 1卷2期 (2009/12) Pp. 1-12

https://doi.org/10.30127/BTWZYYXZZ.200912.0001

摘要

腸躁症臨床可分為腹瀉型、便祕型、腹瀉便祕交替型、黏液便型。中醫學認為，本病病位雖在腸道，但與肝、脾、腎諸臟腑的功能失調密切相關。早期多屬肝鬱脾虛，若夾熱、夾寒、夾痰，可形成肝脾不調、寒熱錯雜；後期多見脾腎陽虛；波及血分可見氣滯血瘀。中醫辨證上，肝鬱脾虛治宜抑肝扶脾，調理氣機，可用痛瀉要方加味；腸道津虧治宜滋水清肝，潤腸通便，藥用一貫煎加減；脾胃虛弱治宜健脾益氣，方藥用參苓白朮散加減。針灸可取足三里、天樞、三陰交等穴。

關鍵字

腸躁症 ； 腹瀉 ； 便秘 ； 脾胃虛弱

並列摘要

Irritable bowel syndrome (IBS) can be divided into diarrhea type, constipation type, alternative type of diarrhea and constipation and mucoid stool type. In the theory of traditional Chinese medicine, although the pathogenic site of the IBS is in the gastrointestinal tract, however it is closely interrelated with visceral dysfunction of liver, spleen and kidney. In its early stage, the symptoms of IBS are mostly due to hepatic congestion and splenic vacuity, if it is combined inflicted with heat, cold or phlegm, then the imbalance of liver and spleen and jumbled heat and cold would be presented; In its late stage, the symptoms of Yang vacuity of iver and kidney are mostly seen; if it is involved with the blood phase, the symptoms of qi stagnation and blood stasis are presented. In the symptomatic pattern identification of Chinese Medicine, the symptoms of hepatic congestion and splenic vacuity should be treated with method of suppressing liver and support spleen with recuperation of mechanism of qi like prescription of aching diarrhea decoction with supplements. The symptoms of fluid loss within gastrointestinal tract should be treated with method of nursing fluid and hepatic purification, moisten intestine and laxatives like prescription of Yi-guan Jian (All-along decoction) with addition and subduction of supplements. The symptoms of gastrointestinal tract vacuity should be treated with method of tonifying spleen and Qi replenishing like prescription of Shenling-bai-zhu-san (Ginseng, Poria and White Atractylodes Decoction) with addition and subduction of supplements. Acupuncture of IBS can choose acupoints like Zusanli (ST36), Tianshu (ST25) and San yin jiao (SP6), etc.

並列關鍵字

Irritable Bowel Syndrome (IBS) ； Diarrhea ； Constipation ； Asthenia of gastrointestinal tract