小柴胡汤及其合方治疗功能性胃肠病症状重叠的临证思路及验案举隅

林云志; 贾越博; 刘雪娇; 杨珂鸣; 王煜姣; 凌江红

doi:10.3969/j.issn.1671-038X.2023.10.08

小柴胡汤及其合方治疗功能性胃肠病症状重叠的临证思路及验案举隅

- 1.
  上海健康医学院附属周浦医院中医科(上海，201318)
- 2.
  上海中医药大学附属曙光医院消化内科
基金项目:
上海市浦东新区卫健委浦东名中医继承人项目(No：PWRzj2020-22)；上海市浦东新区卫健委浦东名中医项目(No：PWRzm2020-16)；国家中医药管理局中医药循证能力建设项目(No：2019XZZX-XH013)；中国民族医药学会科研项目(No：2022Z1048-460302)；上海健康医学院附属周浦医院2019年师资人才百人库(No：ZPBRK-19-10)；上海健康医学院附属周浦医院2020年院级教学课题(No：ZPJXKT-20-26)

详细信息

通讯作者: 凌江红，E-mail：459183870@qq.com

中图分类号: R57

收稿日期: 2023-09-01

刊出日期: 2023-10-15

Clinical thinking and case examples of Xiaochaihu Decoction and its combination in treating overlapping symptoms of functional gastrointestinal disorders

- 1.
  Department of Traditional Chinese Medicine, Zhoupu Hospital, Shanghai Health Medical College, Shanghai, 201318, China
- 2.
  Department of Gastroenterology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine

More Information

Corresponding author: LING Jianghong, E-mail: 459183870@qq.com

Received Date: 01 September 2023

Publish Date: 15 October 2023

摘要

摘要: 功能性胃肠病(FGIDs)是临床常见的无器质性病变的疾患，常有症状重叠，对患者生活质量产生极大的负面影响。其发病机制主要为肠-脑互动异常，中医以“疏肝调枢，健脾和胃”为治法，对该病治疗有着明显优势。小柴胡汤是《伤寒论》中治疗少阳病的经典方之一，能疏肝理气，健脾和胃，临床应用广泛。凌江红教授认为，小柴胡汤方证与FGIDs病机相参、方证相应，在临证中常用小柴胡汤及其合方治疗FGIDs症状重叠，疗效颇佳。兹分享其临证思路和验案如下，以期为各位同道治疗FGIDs症状重叠提供临床新思路。
- 功能性胃肠病 /
- 症状重叠 /
- 验案 /
- 小柴胡汤
Abstract: Functional gastrointestinal disorders(FGIDs) are common clinical diseases without organic disorders(FGIDs), often with overlapping symptoms, which have a great negative impact on the life quality of patients. Its pathogenesis mainly owes to the abnormal interaction between the intestine and the brain. Traditional Chinese Medicine has obvious advantages in treating this disease with the treatment of "soothing the liver and regulating the pivot, strengthening the spleen and stomach". Xiaochaihu Decoction is one of the classic prescriptions for treating Shaoyang disease in Treatise on Febrile Diseases. It can dredge the liver and regulate qi, strengthen the spleen and stomach, and is widely used in clinics. Professor Ling Jianghong believes that Xiaochaihu Decoction and its combination decoctions are related to the pathogenesis of FGIDs and correspond to each other. In clinical practice, Xiaochaihu Decoction and its combination decoctions are often used to treat the overlapping symptoms of FGIDs, and the curative effect is quite good. This article is to share the professor's clinical thinking and experience and to provide new clinical ideas for treating the overlapping symptoms of FGIDs in the same way.
- functional gastrointestinal disorders /
- symptoms overlap /
- verify the case /
- Xiaochaihu Decoction

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参考文献(24)

[1]	Sperber AD, Bangdiwala SI, Drossman DA, et al. Worldwide Prevalence and Burden of Functional Gastrointestinal Disorders, Results of Rome Foundation Global tudy[J]. Gastroenterology, 2021, 160(1): 99-114. doi: 10.1053/j.gastro.2020.04.014
[2]	王辉, 康志龙. 观察氟哌噻吨美利曲辛片治疗伴焦虑抑郁障碍的功能性胃肠病的临床疗效[J]. 世界最新医学信息文摘(连续型电子期刊), 2019, 19(22): 122-123. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSSA201933048.htm
[3]	黄晓英. 四逆散治疗功能性消化不良伴抑郁的疗效观察[J]. 内蒙古中医药, 2022, 41(3): 39-40. doi: 10.16040/j.cnki.cn15-1101.2022.03.036
[4]	罗晓颖, 杨洋, 毛心勇, 等. 中药复方治疗功能性消化不良: 一项随机、双盲、安慰剂对照试验的Meta分析(英文)[J]. 数字中医药(英文版), 2021, 4(4): 273-289. https://www.cnki.com.cn/Article/CJFDTOTAL-DFGF202104003.htm
[5]	温永天, 王凤云, 唐旭东, 等. 运用调中复衡理论诊治功能性胃肠病症状重叠的思路和方法[J]. 中医杂志, 2022, 63(1): 17-20. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZYZ202201006.htm
[6]	周学海. 读医随笔[M]. 北京: 中国中医药出版社, 2007: 318-318.
[7]	Ford AC, Mahadeva S, Carbone MF, et al. Functional dyspepsia[J]. Lancet, 2020, 396(10263): 1689-1702. doi: 10.1016/S0140-6736(20)30469-4
[8]	张悦, 徐枝芳, 李亚男, 等. 基于"脑肠交互"探讨针灸治疗功能性胃肠病的效应机制[J]. 针灸临床杂志, 2022, 38(11): 1-5. https://www.cnki.com.cn/Article/CJFDTOTAL-ZJLC202211001.htm
[9]	de Bortoli N, Tolone S, Frazzoni M, et al. Gastroesophageal reflux disease, functional dyspepsia and irritable bowel syndrome: common overlapping gastrointestinal disorders[J]. Ann Gastroenterol, 2018, 31(6): 639-648.
[10]	魏玮, 刘倩, 荣培晶, 等. 功能性胃肠病"脑肠同调"治法的建立与应用[J]. 中医杂志, 2020, 61(22): 1957-1961. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZYZ202022009.htm
[11]	Wauters L, Talley NJ, Walker MM, et al. Novel concepts in the pathophysiology and treatment of functional dyspepsia[J]. Gut, 2020, 69(3): 591-600. doi: 10.1136/gutjnl-2019-318536
[12]	Wang C, Fang X. Inflammation and Overlap of Irritable Bowel Syndrome and Functional Dyspepsia[J]. J Neurogastroenterol Motil, 2021, 27(2): 153-164.
[13]	Wauters L, Talley NJ, Walker MM, et al. Novel concepts in the pathophysiology and treatment of functional dyspepsia[J]. Gut, 2020, 69(3): 591-600. doi: 10.1136/gutjnl-2019-318536
[14]	Camilleri M. Gastrointestinal hormones and regulation of gastric emptying[J]. Curr Opin Endocrinol Diabetes Obes, 2019, 26(1): 3-10.
[15]	陈维华, 徐国龙, 张明淮, 等. 药对论[M]. 合肥: 安徽科学技术出版社, 1984: 166-166.
[16]	龙飘, 雎世聪, 邹旭峰, 等. 小柴胡汤对肝郁脾虚型功能性消化不良大鼠CCK、CGRP蛋白的影响[J]. 山东中医药大学学报, 2020, 44(3): 296-300, 332. https://www.cnki.com.cn/Article/CJFDTOTAL-SDYX202003016.htm
[17]	戴维. 基于脑肠轴途径探讨小柴胡汤对功能性消化不良大鼠SP、Ghrelin、VIP的影响[D]. 长沙: 湖南中医药大学, 2016.
[18]	桓滢, 高俊, 吴志华, 等. 息风降压汤联合尼莫地平治疗老年性高血压的临床疗效[J]. 中西医结合心脑血管病杂志, 2020, 18(4): 700-702. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYYY202004048.htm
[19]	龙茜, 刘乐平, 郭璇, 等. 基于网络药理学探讨柴胡-黄芩药对治疗功能性消化不良的作用机制[J]. 时珍国医国药, 2019, 30(4): 815-819. https://www.cnki.com.cn/Article/CJFDTOTAL-SZGY201904015.htm
[20]	易志忠. 小柴胡汤加减治疗肝胃不和型功能性消化不良的临床研究[D]. 南宁: 广西中医药大学, 2021.
[21]	税嘉诚. 基于网络药理学探讨人参、甘草、大枣药组对T2DM大鼠食欲的影响及机制研究[D]. 成都: 成都中医药大学, 2021.
[22]	刘红艳. 小柴胡汤治疗2型糖尿病胃轻瘫(肝郁脾虚型)的效果及对患者胃泌素、生长抑制素的影响[J]. 糖尿病新世界, 2021, 24(9): 17-21, 25. https://www.cnki.com.cn/Article/CJFDTOTAL-TNBX202109005.htm
[23]	Tack J, Carbone F. Functional dyspepsia and gastroparesis[J]. Curr Opin Gastroenterol, 2017, 33(6): 446-454.
[24]	唐旭东, 马祥雪. 中西医结合医学研究的突破点: 功能性胃肠病症状重叠的诊疗难题[J]. 中国中西医结合杂志, 2023, 43(1): 97-101. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZXJ202301013.htm