冯五金教授脾胃学术思想继承及运用“六位一体”理念治疗“腹泻型IBS”的临床经验总结
|
摘要
冯五金教授,山西昔阳人,全国第四批继承老中医药专家学术经验指导老师,北京中医药大学本科毕业,享受国务院特殊津贴专家,从事中医临床、科研、教学工作30多年,注重中医现代研究,临床经验丰富,擅长治疗脾胃病,尤其对胃痞、泄泻的疗效更为突出。近年来采用中药榆白散二步灌肠法治疗溃疡性结肠炎,方法独特,为中医治疗疑难肠病开辟了一条新途径。
本论文主要内容：
一、冯五金教授学术渊源：
《内经》、《伤寒论》、《脾胃论》,以及中医脾胃病各家流派给了导师最好的启迪,奠定了他脾胃学术思想基础,导师认为“读经典,勤临床,善思考,会总结”是名医的成才之路。
二、脾胃学说中医经典古籍溯源：
①《内经》为脾胃学说奠定了理论基础,后世脾胃学说的发展,都是以此为出发点。②《伤寒杂病论》奠定了脾胃学说的临床证治基础,张仲景不仅提出了“四季脾旺不受邪”理论,而且在六经论治中,还制定了一系列脾胃病的辨证纲要和治法方药,为脾胃理论的临床应用开辟了广阔的前景。③唐宋金元时期,脾胃学说得以全面的发展,李东垣独树一帜,开脾胃论之先河,法《内经》“土者生万物”的理论,认为脾胃之病多由于虚损造成,临床惯用补中、升阳益气、益胃之法,成为补土学派的鼻祖。④明清时期,脾胃学说进一步充实完善,尤以叶天士对阐发脾胃之阴的论治有卓越的贡献,使脾胃学说逐步发展成为一个完整的理论体系。
三、冯五金学术思想概述：
1、“六位一体”理念治疗功能性胃肠病：功能性胃肠病是一个多因素参与的过程,其病机的多样性和不确定性造成了治疗药物杂乱,治疗效果不稳定的现状。“六位一体”治疗理念,即“以调为先、以通为顺、以和为贵、以平为期、以防为主、以人为本”的提出,提供了新的治疗思路。
2、“病”“证”“症”结合一体治疗脾胃病：提倡治病要重视“协同疗法”,中医药与西医药协同,局部用药与整体治疗协同,药物与非药物疗法协同,以提高疗效。临床诊疗疾病过程中,采用“病”“证”“症”结合一体,从主症选主药以求近功,从主证选主方以图远效,从主病选主法以期治本。
3、重视舌诊：“舌为脾胃之外候,苔乃胃气之所熏蒸”,舌象对脾胃病反映迅敏而准确,为脾胃病辨证用药提供依据。
4、顺应脾胃生理特性,审机定治,动中求衡：①善调气机,升降各司；②寒热并用、辛开苦降；③清温同施、燥润相宜；④谨守病机、经方化裁；⑤标本兼顾,调整气血；⑥久病入络、勿忘化瘀；⑦善疏肝木、兼营脾土；⑧擅用专药、讲究服法。
四、冯五金临床经验总结：
对消化性溃疡、胃食管返流病、慢性功能性便秘、慢性萎缩性胃炎、溃疡性结肠炎、功能性消化不良、散偏方治头痛总结了其临床经验。
五、冯五金教授运用“六位一体”理念治疗“腹泻型IBS"临床经验总结：
目的：采用数理统计和多因素分析方法,结合临床实践,对冯五金教授治疗腹泻型IBS患者中医临床辨证用药进行客观总结,探索其辩证论治规律,总结其临床经验及学术思想,为中医辨证论治腹泻型IBS提供客观科学的证据。
方法：本研究自2010年12月至2012年1月,用临床流行病学调查方法对山西省中医药研究院门诊237例腹泻型IBS病例进行调查,设计证候调查表,焦虑抑郁自评量表,确定调查内容,运用EPldata3.0进行数据库的建立及管理,并采用二次录入的方式进行审核。采用中医计量诊断探讨腹泻型IBS证素,探讨病位、病性的分布规律,统计方法主要采用频数分析、聚类分析、因子分析等多因素分析方法,结合临床实践,对腹泻型IBS患者辨证规律进行客观总结和分析。
结果：
1、腹泻型IBS主要症状为：泄泻>大便稀溏>纳呆>不思饮食>久泻不愈>神疲倦怠；对46个症状通过指标聚类分析结果与中医理论相结合,总结出中医证候规律,4个证型的名称如下：脾胃虚弱证(18.14%)、肝郁脾虚证(48.52%)、脾肾阳虚证(20.25%)、寒热错杂证(13.08%)。
2、用因子分析,将聚类形成的4大证型中的症状、体征变量进行分析,从而确定对整个证型最有贡献度的几个变量,形成辩证要点如下：脾胃虚弱证辨证要点：水谷不化、神疲乏力、食后脘痞；肝郁脾虚证为泻后痛减、心烦易怒、多梦、情绪不畅时腹痛、肠鸣；脾肾阳虚证为喜温喜按、五更泻、形寒肢冷；寒热错杂证为大便不爽、口干口苦、脘腹喜暖。
3、中医证候要素分布规律：病位证素主要在于小肠、大肠、脾、肝、肾；病性证素主要有寒、湿、气滞、气虚、阳虚。
4、用药规律：49种药物频数分析,排前10位的是：黄芪、炮姜、党参、太子参、芡实、莲子肉、陈皮、薏苡仁、砂仁、仙灵脾；治疗药物主要为入脾经(57.14%)、肾经药物(55.10%)；肝经(36.73%)；治疗以温性药和平性药为主。温性药占61.21%,寒凉药占18.36%；治疗以辛温解表药、温里药、收涩药、补气药为主。
5、方剂总结：脾胃虚弱证用参苓白术散；肝郁脾虚证用痛泻要方、柴芍六君子汤；脾肾阳虚证用四神丸加参苓白术散、附子理中丸；寒热错杂证用乌梅丸。
6、抑郁自评量表(SDS)、焦虑自评量表(SAS)得分情况分析：237例患者中,15.61%合并抑郁状态,20.67%合并焦虑状态,5.06%抑郁焦虑状态同时存在。
结论：采用流行病学/DME调查方法,应用指标聚类数理统计和多因素分析方法,结合中医理论,总结出腹泻型IBS中医证候分布规律。以脾虚贯穿疾病始终,以寒、湿、气滞、气虚、阳虚为病性因素,得出4种证型及其辨证要点,治疗以健脾为主,尤其注重温通,时时不忘疏肝、温肾,同时善于调节患者的心理状态。为腹泻型IBS的临床辨证提供了客观依据。
Professor Feng Wujin, Xiyang, Shanxi people, national fourth inherited old academic experience in Chinese medicine expert instructor, graduated from Beijing University of Chinese medicine, enjoying special subsidy of the State Council, work in clinical, research, and teaching of traditional Chinese medicine for more than 30 years, focusing on modern research of traditional Chinese medicine, clinical experience, specializes in treating spleen and stomach diseases, especially on the stomach swelling, diarrhea effect is more prominent. In recent years, with Elm white powder by two steps of traditional Chinese medicine enema in treating ulcerative colitis, unique, traditional Chinese medicine has opened up a new way of treating intestinal diseases.
Mainly content:
ⅠProfessor Feng Wujin's academic sources:
The rights, in the treatise, and the theory of the spleen and stomach and spleen-stomach disease with TCM's schools to tutor the best inspiration, lay the foundation of academic thought in his spleen and stomach, mentors that "read the classics, medical clinic, good thoughts, summary" is a famous doctor's road to success.
Ⅱspleen-stomach theory of traditional Chinese medicine classics of ancient history:
Laid the theoretical foundation for spleen-stomach theory, later generations of spleen-stomach theory development, is taking this as a starting point.②the Treatise on Febrile and Miscellaneous Diseases, clinical treatment with syndrome differentiation of spleen-stomach theory laid the Foundation, Zhang Zhongjing's not only made the "four seasons of spleen in Mong Kok against evil" theory, and on the treatment of six, also developed a series of platform for prescriptions and treatment based on syndrome differentiation of spleen and stomach disease, clinical application of spleen-stomach theory has opened up broad prospects.③tangsongjinyuan, spleen-stomach theory to comprehensive development of Li dongyuan's unique, open theory of spleen and stomach first, by the "all things" theory, saying that due to deficiency of spleen and stomach disease caused by loss, clinical in the common supplement, Sun method of invigorating Qi,nourishing stomach, originator of epoxy PuTTY schools.④in Ming and Qing dynasties, spleen-stomach theory to further enrich the perfect, especially on ye Tianshi's elaboration on treatment of spleen and stomach-yin has made excellent contributions, so that gradually developed into a complete theory of spleen-stomach theory system.
Ⅲ, Feng wujin academic ideas summary:
1, "six to one" concept in the treatment of functional gastrointestinal disorders:the functional gastrointestinal disorders is one of the many factors involved in the process of, its diversity and uncertainty caused by the treatment of clutter, the treatment effect of unstable situation. "
2, disease", "card", "disease" with integrated treatment of spleen and stomach disease: advocating for medical treatment should pay attention to "collaborative therapy", traditional Chinese medicine and Western medicine together, local administration and overall treatment of cooperative, collaborative drug and non-drug therapy to enhance the effect. In the course of clinical diagnosis and treatment of diseases, the use of "disease", "card", "disease" with one, from primary elections with the main charge in order to work, from the main syndrome of primary elections to much effect, from the main main method in order to get to the root.
3, attach importance to the tongue:"tongue and stomach waiting outside, MOSS is the fumigation of stomach Qi", reflect the motion-sensitive and accurate tongue on the spleen and stomach disease, provide the basis for differentiation of spleen and stomach disease
4,comply with the physiological characteristics of the spleen and stomach, machine, and beg for money:①good adjustable gas machine, lifting the Division;②cold, bitter downbearing drop;③Wen Tongshi clearance, dry run fitting;④keep the machine, by the side of the Conference;⑤the samples into account and adjust blood;⑥long illness into the collaterals, don't forget to remove blood stasis;⑦good and soothing the liver and spleen wood, and camp;⑧unauthorized drugs, pay attention to the law.
IV Clinical experience of Professor Feng
Peptic ulcers, gastroesophageal reflux disease, chronic constipation, chronic atrophic gastritis, ulcerative colitis, functional dyspepsia, folk prescription headache summarizes their clinical experience
V The Clinical experience of Professor Feng wujin using "six as one" concept treating "diarrhea type IBS"
Objective:Using the mathematical statistics and factor analysis method and in combination with clinical practice to objectively summarize the treatment of diarrhea IBS by Professor Feng wujin, explore the dialectical differentiation rule, and to sum up the clinical experience and academic thinking, and provide for Chinese medicine diagnosis treatment of diarrhea IBS objective scientific evidence.
Methods:This study was started from December 2010 to January 2012, with clinical epidemiological survey method of shanxi institute of Chinese medicine outpatient service 237 cases of diarrhea cases of IBS survey, designed syndrome questionnaire, anxiety depression self rating scale, determined the content, the use of EPldata3.0 database establishment and management, and the second entry way audit. The quantitative diagnosis of traditional Chinese medicine explore diarrhea type IBS syndrome factor and explore a disease of sex disease, distribution, statistical methods mainly adopts frequency analysis, cluster analysis, factor analysis and factor analysis method and in combination with clinical practice, the type of diarrhea IBS patients dialectical rule of objective concluded and analyzed.
Results:1.This study's 237 patients is composed of 43.45% men and 52.32% women; Age distribution in 40.61±12.91 years; Course in 27.63±18.04 months.
2. Diarrhea type main symptoms IBS for:diarrhea> defecate rare discharge takes place > don't think of food, stay not more> long diarrhea; Symptoms of 46 by clustering analysis results and the index of traditional Chinese medicine theory, and the combination of traditional Chinese medical syndrome sums up the rule, four card type name as follows: spleen weak card (18.14%), spleen deficiency stomach (48.52%), spleen and kidney Yang syndrome (20.25%), cold du syndrome (13.08%).
3.Useing orthogonal rotating the factor analysis clustery form the four big type of symptoms, analyzed signs variable, and conclude the type of most contribution several variables, form the dialectical points as follows:spleen syndrome differentiation weak point: food don't turn, god, often after food weary force new; Spleen deficiency stomach to purge pain reduction, upset after irritability, dream, mood when not free of abdominal pain, bowel sounds; Spleen and kidney Yang card for pleased with warm and press, diarrhea, form even cold limbs cold; Cold du card is defecate not great, dry mouth bitter, often abdomen xi warm.
4.Chinese medicine syndrome factor distribution rule:a disease syndrome factor lies mainly in the small intestine, e., spleen, liver, kidney; Sexual disease syndrome factor mainly have cold, wet, and qi stagnation, Yang, qi.
5, drug laws:49 kinds of drug frequency analysis, the top 10:liquorice, big jujube, dangshen, prince Edward and euryale seed, lotus seed, meat, dried tangerine or orange peel, kindhearted YiRen, sand benevolence, faeries spleen; Treatment for the main spleen (57.14%), kidney by the drug (55.10%); The liver (36.73%); The treatment to temperature sexual medicine peace sexual medicine give priority to. Wen sexual medicine 61.21%, cold LiangYao accounted for 18.36%; the treatment is mainly about XinWen XieBiao medicine, Chinese traditional medicine, and temperature acerbity collect medicine, fill gas medicine.
6.Formula summary:spleen with weak card and limit lingya scattered; Spleen deficiency stomach in pain diarrhea YaoFang, wood Que 6 gentleman soup; Spleen and kidney Yang card with four god pill+and lingya scattered or proved in Daniel large-headed atractylodes pills; Cold du card with ebony pill.
7.Depression self rating scale (SDS), anxiety from rating scale (SAS) score analysis:237 patients,15.61% merger depressed, anxious state with 20.67%,5.08% anxiety state also present.
Conclusion:
The epidemiological/DME survey methods, application index clustering mathematical statistics and many factor analysis method with traditional Chinese medicine theory, summarizes diarrhea type IBS syndromes distribution rule. To the spleen deficiency disease always throughout, with cold, wet, and qi stagnation, Yang, qi for disease sexual factors, draw four card type and key points of syndrome differentiation, treatment to the spleen is given priority to, especially pay attention to WenTong, always don't forget ShuGan, wen kidney, and good at adjusting patients psychological state. For diarrhea clinical syndrome differentiation type IBS provides an objective basis.
本论文主要内容：
一、冯五金教授学术渊源：
《内经》、《伤寒论》、《脾胃论》,以及中医脾胃病各家流派给了导师最好的启迪,奠定了他脾胃学术思想基础,导师认为“读经典,勤临床,善思考,会总结”是名医的成才之路。
二、脾胃学说中医经典古籍溯源：
①《内经》为脾胃学说奠定了理论基础,后世脾胃学说的发展,都是以此为出发点。②《伤寒杂病论》奠定了脾胃学说的临床证治基础,张仲景不仅提出了“四季脾旺不受邪”理论,而且在六经论治中,还制定了一系列脾胃病的辨证纲要和治法方药,为脾胃理论的临床应用开辟了广阔的前景。③唐宋金元时期,脾胃学说得以全面的发展,李东垣独树一帜,开脾胃论之先河,法《内经》“土者生万物”的理论,认为脾胃之病多由于虚损造成,临床惯用补中、升阳益气、益胃之法,成为补土学派的鼻祖。④明清时期,脾胃学说进一步充实完善,尤以叶天士对阐发脾胃之阴的论治有卓越的贡献,使脾胃学说逐步发展成为一个完整的理论体系。
三、冯五金学术思想概述：
1、“六位一体”理念治疗功能性胃肠病：功能性胃肠病是一个多因素参与的过程,其病机的多样性和不确定性造成了治疗药物杂乱,治疗效果不稳定的现状。“六位一体”治疗理念,即“以调为先、以通为顺、以和为贵、以平为期、以防为主、以人为本”的提出,提供了新的治疗思路。
2、“病”“证”“症”结合一体治疗脾胃病：提倡治病要重视“协同疗法”,中医药与西医药协同,局部用药与整体治疗协同,药物与非药物疗法协同,以提高疗效。临床诊疗疾病过程中,采用“病”“证”“症”结合一体,从主症选主药以求近功,从主证选主方以图远效,从主病选主法以期治本。
3、重视舌诊：“舌为脾胃之外候,苔乃胃气之所熏蒸”,舌象对脾胃病反映迅敏而准确,为脾胃病辨证用药提供依据。
4、顺应脾胃生理特性,审机定治,动中求衡：①善调气机,升降各司；②寒热并用、辛开苦降；③清温同施、燥润相宜；④谨守病机、经方化裁；⑤标本兼顾,调整气血；⑥久病入络、勿忘化瘀；⑦善疏肝木、兼营脾土；⑧擅用专药、讲究服法。
四、冯五金临床经验总结：
对消化性溃疡、胃食管返流病、慢性功能性便秘、慢性萎缩性胃炎、溃疡性结肠炎、功能性消化不良、散偏方治头痛总结了其临床经验。
五、冯五金教授运用“六位一体”理念治疗“腹泻型IBS"临床经验总结：
目的：采用数理统计和多因素分析方法,结合临床实践,对冯五金教授治疗腹泻型IBS患者中医临床辨证用药进行客观总结,探索其辩证论治规律,总结其临床经验及学术思想,为中医辨证论治腹泻型IBS提供客观科学的证据。
方法：本研究自2010年12月至2012年1月,用临床流行病学调查方法对山西省中医药研究院门诊237例腹泻型IBS病例进行调查,设计证候调查表,焦虑抑郁自评量表,确定调查内容,运用EPldata3.0进行数据库的建立及管理,并采用二次录入的方式进行审核。采用中医计量诊断探讨腹泻型IBS证素,探讨病位、病性的分布规律,统计方法主要采用频数分析、聚类分析、因子分析等多因素分析方法,结合临床实践,对腹泻型IBS患者辨证规律进行客观总结和分析。
结果：
1、腹泻型IBS主要症状为：泄泻>大便稀溏>纳呆>不思饮食>久泻不愈>神疲倦怠；对46个症状通过指标聚类分析结果与中医理论相结合,总结出中医证候规律,4个证型的名称如下：脾胃虚弱证(18.14%)、肝郁脾虚证(48.52%)、脾肾阳虚证(20.25%)、寒热错杂证(13.08%)。
2、用因子分析,将聚类形成的4大证型中的症状、体征变量进行分析,从而确定对整个证型最有贡献度的几个变量,形成辩证要点如下：脾胃虚弱证辨证要点：水谷不化、神疲乏力、食后脘痞；肝郁脾虚证为泻后痛减、心烦易怒、多梦、情绪不畅时腹痛、肠鸣；脾肾阳虚证为喜温喜按、五更泻、形寒肢冷；寒热错杂证为大便不爽、口干口苦、脘腹喜暖。
3、中医证候要素分布规律：病位证素主要在于小肠、大肠、脾、肝、肾；病性证素主要有寒、湿、气滞、气虚、阳虚。
4、用药规律：49种药物频数分析,排前10位的是：黄芪、炮姜、党参、太子参、芡实、莲子肉、陈皮、薏苡仁、砂仁、仙灵脾；治疗药物主要为入脾经(57.14%)、肾经药物(55.10%)；肝经(36.73%)；治疗以温性药和平性药为主。温性药占61.21%,寒凉药占18.36%；治疗以辛温解表药、温里药、收涩药、补气药为主。
5、方剂总结：脾胃虚弱证用参苓白术散；肝郁脾虚证用痛泻要方、柴芍六君子汤；脾肾阳虚证用四神丸加参苓白术散、附子理中丸；寒热错杂证用乌梅丸。
6、抑郁自评量表(SDS)、焦虑自评量表(SAS)得分情况分析：237例患者中,15.61%合并抑郁状态,20.67%合并焦虑状态,5.06%抑郁焦虑状态同时存在。
结论：采用流行病学/DME调查方法,应用指标聚类数理统计和多因素分析方法,结合中医理论,总结出腹泻型IBS中医证候分布规律。以脾虚贯穿疾病始终,以寒、湿、气滞、气虚、阳虚为病性因素,得出4种证型及其辨证要点,治疗以健脾为主,尤其注重温通,时时不忘疏肝、温肾,同时善于调节患者的心理状态。为腹泻型IBS的临床辨证提供了客观依据。
Professor Feng Wujin, Xiyang, Shanxi people, national fourth inherited old academic experience in Chinese medicine expert instructor, graduated from Beijing University of Chinese medicine, enjoying special subsidy of the State Council, work in clinical, research, and teaching of traditional Chinese medicine for more than 30 years, focusing on modern research of traditional Chinese medicine, clinical experience, specializes in treating spleen and stomach diseases, especially on the stomach swelling, diarrhea effect is more prominent. In recent years, with Elm white powder by two steps of traditional Chinese medicine enema in treating ulcerative colitis, unique, traditional Chinese medicine has opened up a new way of treating intestinal diseases.
Mainly content:
ⅠProfessor Feng Wujin's academic sources:
The rights, in the treatise, and the theory of the spleen and stomach and spleen-stomach disease with TCM's schools to tutor the best inspiration, lay the foundation of academic thought in his spleen and stomach, mentors that "read the classics, medical clinic, good thoughts, summary" is a famous doctor's road to success.
Ⅱspleen-stomach theory of traditional Chinese medicine classics of ancient history:
Laid the theoretical foundation for spleen-stomach theory, later generations of spleen-stomach theory development, is taking this as a starting point.②the Treatise on Febrile and Miscellaneous Diseases, clinical treatment with syndrome differentiation of spleen-stomach theory laid the Foundation, Zhang Zhongjing's not only made the "four seasons of spleen in Mong Kok against evil" theory, and on the treatment of six, also developed a series of platform for prescriptions and treatment based on syndrome differentiation of spleen and stomach disease, clinical application of spleen-stomach theory has opened up broad prospects.③tangsongjinyuan, spleen-stomach theory to comprehensive development of Li dongyuan's unique, open theory of spleen and stomach first, by the "all things" theory, saying that due to deficiency of spleen and stomach disease caused by loss, clinical in the common supplement, Sun method of invigorating Qi,nourishing stomach, originator of epoxy PuTTY schools.④in Ming and Qing dynasties, spleen-stomach theory to further enrich the perfect, especially on ye Tianshi's elaboration on treatment of spleen and stomach-yin has made excellent contributions, so that gradually developed into a complete theory of spleen-stomach theory system.
Ⅲ, Feng wujin academic ideas summary:
1, "six to one" concept in the treatment of functional gastrointestinal disorders:the functional gastrointestinal disorders is one of the many factors involved in the process of, its diversity and uncertainty caused by the treatment of clutter, the treatment effect of unstable situation. "
2, disease", "card", "disease" with integrated treatment of spleen and stomach disease: advocating for medical treatment should pay attention to "collaborative therapy", traditional Chinese medicine and Western medicine together, local administration and overall treatment of cooperative, collaborative drug and non-drug therapy to enhance the effect. In the course of clinical diagnosis and treatment of diseases, the use of "disease", "card", "disease" with one, from primary elections with the main charge in order to work, from the main syndrome of primary elections to much effect, from the main main method in order to get to the root.
3, attach importance to the tongue:"tongue and stomach waiting outside, MOSS is the fumigation of stomach Qi", reflect the motion-sensitive and accurate tongue on the spleen and stomach disease, provide the basis for differentiation of spleen and stomach disease
4,comply with the physiological characteristics of the spleen and stomach, machine, and beg for money:①good adjustable gas machine, lifting the Division;②cold, bitter downbearing drop;③Wen Tongshi clearance, dry run fitting;④keep the machine, by the side of the Conference;⑤the samples into account and adjust blood;⑥long illness into the collaterals, don't forget to remove blood stasis;⑦good and soothing the liver and spleen wood, and camp;⑧unauthorized drugs, pay attention to the law.
IV Clinical experience of Professor Feng
Peptic ulcers, gastroesophageal reflux disease, chronic constipation, chronic atrophic gastritis, ulcerative colitis, functional dyspepsia, folk prescription headache summarizes their clinical experience
V The Clinical experience of Professor Feng wujin using "six as one" concept treating "diarrhea type IBS"
Objective:Using the mathematical statistics and factor analysis method and in combination with clinical practice to objectively summarize the treatment of diarrhea IBS by Professor Feng wujin, explore the dialectical differentiation rule, and to sum up the clinical experience and academic thinking, and provide for Chinese medicine diagnosis treatment of diarrhea IBS objective scientific evidence.
Methods:This study was started from December 2010 to January 2012, with clinical epidemiological survey method of shanxi institute of Chinese medicine outpatient service 237 cases of diarrhea cases of IBS survey, designed syndrome questionnaire, anxiety depression self rating scale, determined the content, the use of EPldata3.0 database establishment and management, and the second entry way audit. The quantitative diagnosis of traditional Chinese medicine explore diarrhea type IBS syndrome factor and explore a disease of sex disease, distribution, statistical methods mainly adopts frequency analysis, cluster analysis, factor analysis and factor analysis method and in combination with clinical practice, the type of diarrhea IBS patients dialectical rule of objective concluded and analyzed.
Results:1.This study's 237 patients is composed of 43.45% men and 52.32% women; Age distribution in 40.61±12.91 years; Course in 27.63±18.04 months.
2. Diarrhea type main symptoms IBS for:diarrhea> defecate rare discharge takes place > don't think of food, stay not more> long diarrhea; Symptoms of 46 by clustering analysis results and the index of traditional Chinese medicine theory, and the combination of traditional Chinese medical syndrome sums up the rule, four card type name as follows: spleen weak card (18.14%), spleen deficiency stomach (48.52%), spleen and kidney Yang syndrome (20.25%), cold du syndrome (13.08%).
3.Useing orthogonal rotating the factor analysis clustery form the four big type of symptoms, analyzed signs variable, and conclude the type of most contribution several variables, form the dialectical points as follows:spleen syndrome differentiation weak point: food don't turn, god, often after food weary force new; Spleen deficiency stomach to purge pain reduction, upset after irritability, dream, mood when not free of abdominal pain, bowel sounds; Spleen and kidney Yang card for pleased with warm and press, diarrhea, form even cold limbs cold; Cold du card is defecate not great, dry mouth bitter, often abdomen xi warm.
4.Chinese medicine syndrome factor distribution rule:a disease syndrome factor lies mainly in the small intestine, e., spleen, liver, kidney; Sexual disease syndrome factor mainly have cold, wet, and qi stagnation, Yang, qi.
5, drug laws:49 kinds of drug frequency analysis, the top 10:liquorice, big jujube, dangshen, prince Edward and euryale seed, lotus seed, meat, dried tangerine or orange peel, kindhearted YiRen, sand benevolence, faeries spleen; Treatment for the main spleen (57.14%), kidney by the drug (55.10%); The liver (36.73%); The treatment to temperature sexual medicine peace sexual medicine give priority to. Wen sexual medicine 61.21%, cold LiangYao accounted for 18.36%; the treatment is mainly about XinWen XieBiao medicine, Chinese traditional medicine, and temperature acerbity collect medicine, fill gas medicine.
6.Formula summary:spleen with weak card and limit lingya scattered; Spleen deficiency stomach in pain diarrhea YaoFang, wood Que 6 gentleman soup; Spleen and kidney Yang card with four god pill+and lingya scattered or proved in Daniel large-headed atractylodes pills; Cold du card with ebony pill.
7.Depression self rating scale (SDS), anxiety from rating scale (SAS) score analysis:237 patients,15.61% merger depressed, anxious state with 20.67%,5.08% anxiety state also present.
Conclusion:
The epidemiological/DME survey methods, application index clustering mathematical statistics and many factor analysis method with traditional Chinese medicine theory, summarizes diarrhea type IBS syndromes distribution rule. To the spleen deficiency disease always throughout, with cold, wet, and qi stagnation, Yang, qi for disease sexual factors, draw four card type and key points of syndrome differentiation, treatment to the spleen is given priority to, especially pay attention to WenTong, always don't forget ShuGan, wen kidney, and good at adjusting patients psychological state. For diarrhea clinical syndrome differentiation type IBS provides an objective basis.
引文
[1]胡永军,孟静岩《黄帝内经》脾胃理论析要[J].中华中医药学刊,2007,4,25(4)：798-799.
[2]刘志新.黄金刚, 《黄帝内经》与脾胃学说[J].黑龙江中医药,2010.4(4)：49-50.
[3]王喆.高慧霞.《伤寒论》顾护脾胃学术思想浅析[J].山西中医学院学报.2010.11(4)：7-8.
[4]郎世平.唐犀麟.《伤寒论》脾胃病证治探讨[J].中国实用医药.2009.4(16)：243-244.
[5]刘晖.《伤寒论》脾胃学说浅识[J].甘肃中医学院学报.2004.21(1)：15-16.
[6]曹洋.《伤寒论》重视脾胃的学术思想探析[J].内蒙古中医药.2008.6(1)：58-59.
[7]夏军权.仲景脾胃学说临证启迪[J].辽宁中医药大学学报.2011.13(3)：14-15.
[8]杨小红,顾武军.论顾护脾胃在仲景学术思想中的重要地位.辽宁中报,2004,6(6)：443-444
[9]王剑发,宋炳礼.李东垣“脾升胃降”学术思想阐析.辽宁中医学院学报,2006,8(2)34-35
[10]董振华.李东垣对脾胃学说的贡献.现代远程教育,2005,3(11)：19-21
[11]徐寿生.李果脾胃阴阳升降理论探讨.安徽中医学院学报,1999,18(4)：9-10
[12]李赛美.从《脾胃论》看东垣对仲景学说的继承与发展.广州中医药大学学报,2007,24(1)：76-77
[13]王改仙.郭志伟.从《脾胃论》谈药后调理.中国民间疗法,2011,19(7)：61
[14]危北海.脾胃学说的形成.山东中睦学院学报,1983,7(4)：58-60
[15]宇文亚.孙思邈治疗脾胃病理论与方药探讨.辽宁中医杂志,2007,34(6)：738-739
[16]栾胜军.学习医家张元素的体会.中国现代药物应用,2008,2(13)：109-110
[17]翟玉民.张元素学术思想浅探.中医临床研究,2010,2(5)：122-123
[18]韩向东.赵莉.薛己《内科摘要》学术思想探析.辽宁中医学院学报,2005,7(4)：351-352
[19]唐伟华.孙世发.景岳方剂用药规律研究.山西中医药学报,2010,38(4)：53-54
[20]张晶.张宗明.张景岳“五脏体用养阴法”探析.甘肃中医,2008,21(10)：3-4
[21]徐晓东.李中梓治泻九法.吉林中医药,2009,29(12)：1098
[22]王维.李中梓泄泻学术思想探析.中医研究,2005,18(5)：61-62
[23]郑星.叶天士胃阴学说探析.上海中医药杂志,2002,12：34-35
[24]黄英志主编.叶天士医学全书.中国中医药出版社,1999,85-87
[1]Talley NJ.The functional gastrointestinal disorders and the Rome Ⅱ process Gut[J].1999, 45(Suppl Ⅱ):111-115
[2]Dressan DA.Richter JE, Talley NJ, et al.The functional Gastrointestinal Disorders[J].Boston:little Brown & Co,1994,1-74
[3]李瑜.精神心理异常与功能性胃肠疾病的关系[J].中华医学杂志,1999,79(10)：799～780
[4]周福生,张庆宏,黄志新,等.胃肠功能性疾病中医疗效评价与生存质量关系初探[J].中国中西医结合杂志。2001。21(10)：738.
[5]吴敦序.中医基础理论[M].上海：上海科技出版社,1995,42
[6]刘淑新.论“正气存内,邪不可干”及其在临床上的意义[J].中医函授通讯,1994,(6)：24
[7]中华消化学会胃肠动力学组.我国慢性便秘的诊治指南[J].中国全科医学,2005,8(2)：119-121
[8]刘建新,邱国海,傅志雄.四逆散加味合替加色罗治疗便秘型肠易激综合征的临床研究[J].中医药学刊,2006,24(8)：1460-1461.
[9]陈锦辉.白术润肠汤治疗便秘型肠易激综合征71例[J].新中医,2005,37(10)：76.
[10]学宝,胡玲.枳术汤加减治疗便秘型肠易激综合征39例[J].新中医,2003,35(6)：63-64.
[11]吴学琴,四磨汤加西沙比利治疗便秘型肠易激综合征28例[J].河北医药,2003,25(3)：203.
[12]莫滚,何焕平.健脾理肠汤治疗便秘型肠易激综合征96例[J].中国中西医结合消化杂志,2008,16(3)：206-207.
[13]高强,李慧臻.宣肺理气活血法治疗便秘型肠易激综38例[J].吉林中医药,2007,27(12)： 25-26.
[14]赵黎.便秘型肠易激综合征从毒论治[J].新中医,2009,41(11)：119.
[15]王奎平.疏肝理气润肠治疗IBS-C[J]浙江中医杂志,2004：39(1)：125.
[16]李富增.加昧麻仁润肠丸治疗便秘型肠易激综合征40例[J].山西中医,2004；20(3)：36.
[17]柳梅.益肾平肝祛瘀治疗便秘型肠易激综合症57例[J].河北中医,2004；26
[18]林群莲,黄复盛.宣肺调气法治疗IBS-C36例[J].福建中医药,2002；33(4)：23-24.
[19]张蜀,吴至久,廖伯年.逍遥散加味治疗便秘型肠易激综合征27例[J].实用中医内科杂志,2008,22(3)：31.
[20]阙立明.加味六磨汤治疗便秘型肠易激综合征临床观察[J].实用中医内科杂志,2008,22(12)：31.
[21]张家炎.疏肝健脾法治疗便秘型肠易激综合征的临床疗效分析[J].甘肃中医,2009,22(7)：23-24.
[22]高强,李慧臻.宣肺理气活血法治疗便秘型肠易激综合征38例[J].吉林中医药,2007,27(12)：25-26.
[23]王长来.养血通腑汤治疗肠易激综合征便秘型50例[J].江西中医药,2008,39(303)：21.
[24]吕永慧,汪运鹏.通幽清治疗便秘型肠易激综合征疗效观察[J],中国中药杂志[J],2008,33(6)：691-693.
[25]刘谦民,令狐恩强,刘运详.主编.功能性胃肠病学.第一版.北京：人民军医出版社2003：45.
[26]李延青,杨云生,陈建.肠易激综合征[M].北京：中国医药科技出版社,2005：44-46.
[27]中华医学会消化病学分会.中国慢性胃炎共识[J].现代消化及介入诊疗,2007,12(1)：55-62.
[28]张万岱,陈治水,危北海,《慢性胃炎的中西医结合诊治方案》,世界华人消化杂志,2004；12(11)：2697-2700
[29]危北海,《中西医结合消化病学》,人民卫生出版社
[30]苏娟萍,冯五金,肠必安灌肠治疗溃疡性结肠炎的临床研究,山西中医学院学报,20067(3)：30-31
[31]贾志新,冯五金,肠必安对乙酸刺激法致大鼠溃疡性结肠炎的实验研究,山西中医学院学报20056(2)：45-46
[32]苏娟萍,冯五金,肠必安灌肠治疗溃疡性结肠炎36例临床分析,山西中医学院学报20045(4)：12-13
[33]贾志新, 冯五金,肠必安治疗免疫致敏法致大鼠溃疡性结肠炎的实验研究,2005,中国中西医结合学会第十七次全国消化系统疾病学术研讨会
[34]贾慧,溃疡性结肠炎辨治体会,中外健康文摘2008,3(5)113-114
[35]董秀娟,邱向红,唐梁,溃疡性结肠炎中医药治疗进展,北京中医药大学学报(中医临床版)2007,14(4)：44-46
[36]吴彩娥；伍永娟；潘文姣；程清琳；中药二步灌肠治疗溃疡性结肠炎30例,河北中医2002, (9)
[37]单兆伟,刘沈林,黄俊著.内科多发病中西医综合治疗,北京：人民卫生出版社
[38]张福奎,功能性消化不良的研究进展,中国医刊,2003,8(9)：27-28
[39]莫剑忠,袁耀宗,邹多武主编,消化系功能性和动力障碍性疾病,上海：上海科学技术出版社,2005,7
[40]马汴梁主编,中西医结合胃肠病学,北京中医古籍出版社,1993.4
[41]刘文,张大伟,中药对胃肠运动功能的影响,中国中西医结合脾胃杂志,1998,6(5)：192
[42]陈露,功能性消化不良的病因研究进展[J],临床消化病杂志,2003,15(4)：187-189
[43]潘志恒,曹世植,现代胃肠病学[M],北京：科学出版社,1998,854-855
[44]刘群,中医治疗功能性消化不良的进展, 中成药,2002,24(7)：541-3
[45]萧树东,开展对功能性消化不良的研究[J],中华消化杂志,1994,14(5)：249
[1]复旦大学上海医学院.实用内科学第12版[M].人民卫生出版社,2006年.
[2]叶任高,陆再英.内科学[M].人民卫生出版社,2004,2月第6版.
[3]李延青.肠易激综合征[J].中国医药科技出版社,2005,7(1).
[4]宗春华.肠易激综合征manning诊断标准的评价[J].上海第二军医大学学报,2004,117-119.
[5]功能性胃肠疾病的诊断标准-Rome2标准[J].临床内科学杂志,2000,17(2)：27-129.
[6]张正利.肠易激综合征中医论治溯源[J].中国中医基础医学杂志,2001,7(7)：48-50.
[7]葛恒松.辨证分型治疗肠易激综合征62例[J].陕西中医,1998,19(7)：331.
[8]周向阳,王世勋,王荣林.四逆散为主辨证治疗肠易激综合征120例[J].国医论坛,1999,14(1)：8.
[9]申亚东,张峰.加味逍遥散治疗腹泻型肠易激综合征45例[J].河南中医药学刊,2000,15(6)：37.
[10]徐佩华,缪平,应丹松.平肝健脾法治疗肠易激综合征38例[J].实用中医药杂志,1999,15(1)：17.
[11]刘保成.从肝气阳虚论治肠易激综合征临床研究[J].中国中西医结合消化杂志,2001,9(3)：71.
[12]朱耀群,陈军贤,李军.补中益气汤加减治疗肠易激综合征89例疗效观察[J].实用医学杂志,1996,12(6)：399.
[13]范京国,周东民.缓急汤治疗腹泻型肠易激综合征42例[J].实用中医药杂志,2001,17(11)：7.
[14]于宁.从肺论治肠易激综合征的理论文献研究[D].北京中医药大学,2011.
[15]董晓明.温肾健脾法治疗肠易激综合征82例.浙江中医学院学报,1999,23(1)：36
[16]孙为宏,兰著玲.中西医结合治疗肠道激惹综合征[J].实用中医药杂志,1999,15(8)：34.
[17]戈力.自拟愈泻汤治疗肠易激综合征32例临床体会[J].甘肃中医,2000,13(1)：25-26.
[18]郭汉卿.从风论治肠易激综合征探析[J].实用中医内科杂志,2002,16(4)：17.
[19]类承法,初立志.从痰论治肠易激综合征48例[J].山东中医杂志,2000,19(4)：206.
[20]陈伟红.自拟安肠汤治疗肠易激综合征39例[J].广西中医药,1999,22(4)：8.
[21]张艳国.血府逐瘀汤加味治疗肠易激综合征65例[J].河北中医药学报,2001,16(2)：18.
[22]郑荣辉.理气活血法治疗肠易激综合征47例[J].浙江中西医结合杂志,2003,13(5)：297.
[23]汪静凤,刘煜.抑肝扶脾化痰祛癖法治疗肠易激综合征36例[J].南京中医药大学学报,2000,16(4)：250.
[24]张华,蝎亚萍,蒙雅群.肠易激综合征辨证施治体会[J].陕西中医学院学报,2002,25(5)：20-21.
[25]刘勇,潘明义.辨证分型治疗肠易激综合征30例[J].山东中医杂志,2000,19(6)：348.
[26]沈明,刘杰.中西医结合治疗肠易激综合征40例[J].中西医结合内科杂志,1998,11(12)：1090.
[27]张淑娥,张希全.参苓白术散加味治疗肠易激综合征52例[J].陕西中医,1998,19(7)：312.
[28]刘力,沈舒文.肠易激综合征中医辨证论治[J].实用中医内科杂志,2002,16(3)：157-158.
[29]谢广仁.肠易激综合征辨治方法探讨[J].陕西中医,1999,20(9)：404.
[30]任赞屹.中西医结合治疗肠易激综合征86例疗效观察[J].河南中医学院学报,2004,19(6)：58.
[31]黄穗平,梁乃津.从肝论治肠易激综合征经验[J].新中医,1996,28(5)：9.
[32]李剑锋.肠易激综合征辨证分析[J].2008,3(3)：165-166.
[33]李振彬.周仲瑛教授治疗肠易激综合征的经验[J].新中医,1997,29(8)：6.
[34]吴成胜.从肝脾论治腹泻型肠易激综合征探微[J].山东中医药大学学报,2004,28(1)：45.
[35]李一新.电针加耳穴治疗肠易激综合征21例[J].针灸临床杂志,2002,18(2)：29.
[36]敖学艳,王宁.耳压点穴按摩治疗肠易激综合征60例[J].针灸临床杂志,2002,18(3)：36.
[37]徐运瑜.背部走罐治疗肠易激综合征48例[J].浙江中医杂志,2007,42(3)：163.
[38]钟文元.足反射法结合腹部按摩法治疗肠易激综合征疗效观察[J].双足与保健,2000,(4)：61.
[39]黄政德.针刺推拿结合治疗肠易激综合征[J].中国针灸,2006,26(10)：717-718.
[1]李瑜.精神心理异常与功能性胃肠疾病的关系[J].中华医学杂志,1999,79(10)：799～780
[2]周福生,张庆宏,黄志新,等.胃肠功能性疾病中医疗效评价与生存质量关系初探[J].中国中西医结合杂志。2001。21(10)：738.
[3]潘国宗,鲁素彩,柯美云,等.北京地区肠易激综合征的流行病学研究：一个整群、分层、随机调查[J].中华流行病学杂志,2000,21：26-29.
[4]申亚东,张峰.加味逍遥散治疗腹泻型肠易激综合征85例[J].河南中医药学刊,2000,15(6)：37.
[5]朱文锋.中医诊断学[M].北京：中国中医药出版社,2002,2：235
[6]朱文锋.证素辨证学[M].北京：人民卫生出版社,2008：：88-159
[7]黄碧群,朱镇华.证素等概念的辨析中华中医药杂志[J].2005,20(5)：273
[8]孙振球.医学统计学[M].北京：人民卫生出版社,2002
[9]金丕焕.医用统计方法[M].上海：复旦大学出版社,2002
[10]吴敦序.中医基础理论[M].上海：上海科技出版社,1995,42
[11]Chang FY, Lu C I. Irritable bowel syndrome in the 21st century:perspectives from Asia or South-east Asia[J]. J Gastroenterol Hepatol,2007,22(1):4-12.
[12]Vandvik P O, Lydersen S, Farup P G. PrevMence, comorbidit and impact of irritable bowel syndrome in Norway [J]. Scand Gastroenterol.2006,41(4):650-656.
[13]Schmulson M, Ortiz O, Santiago-Lomeli M, et al. Frequency of functional bowel disorders among healthy volunteers in Mexico City [J]. Dig Dis,2006,24(3-4): 342-347.
[14]熊理守,陈曼湖,陈惠新,等.广东省社区人群肠易激综合征的流行病学研究[J].中华医学杂志,2004,84：278-228.
[15]Drossman D A. The functional gastrointestinal disorders and the RomeⅢ process[J]. Gastroenterology,2006,130(5):1377-1390.
[16]Levy R L, Jones K R, Whitehead W E, et al. Irritable bowel syndrome in twins:heredity and social learning both contribute to etiology[J]. Gastroenterology,2001,121(4): 799-804.
[17]Tornblom H, Lindberg G, Nvberq B. et al. Full-thickness biopsy of the jejunum reveals inflammation and enteric neuropathy in irritable bowel syndrome [J]. Gastroenterology, 2002,123(6):1972-1979.
[18]王伟岸,钱家鸣,潘国宗.结肠黏膜肥大细胞活化在肠易激综合征发病中的作用[J].中华消化杂志,2003,23(5)：263-266.
[19]潘国宗.肠道感染在肠易激综合征发病中的作用[J].胃肠病学,2006,11(6)：321-322.
[20]De Ponti F, Tonini M. Irritable bowel syndrome:new agents targeting serutonin receptor subtypes[J]. Drugs,2001,61(3):317-332.
[21]张希全.思密达与洛哌丁胺对腹泻型肠易激综合征疗效的比较研究[J].中国临床药理学杂志,2000,16(1)：25-26.
[22]莫文辉,郭传勇.微生态制剂在肠易激综合征中的临床应用及评价[J].世界临床药物,2008,29(12)：722-724.
[23]朱耀群,陈军贤,李军.补中益气汤加减治疗肠易激综合征89例临床疗效观察[J].实用医学杂志,1996,12(6)：399.
[24]范京国,周东民.缓急汤治疗腹泻型肠易激综合征42例[J].实用中医药杂志,2001,17(11)：7.
[25]原培谦.辨证治疗肠易激综合征76例[J].北京中医药大学学报(中医临床版),2007,14(2)：14-15.
[26]吴华清,姚保泰.肠易激综合征辨治[J].山东中医杂志,2007,26(6)：393-394.
[27]王伟伟.肠易激综合征的中医诊治浅探[J].浙江中西医结合杂志,2009,19(9)：552.
[28]彭林.辨证分型治疗泄泻型肠易激综合征58例[J].江西中医药,2005,36(6)：27-28.
[29]汪运鹏,吕永慧.便秘型肠易激综合征病因病机及治疗研究进展[J].现代消化及介入治疗,2007,12(2)：128.
[30]刘万里.肠易激综合征62例临床观察[J].江苏中医药,2009,41(8)：35.
[31]吴莉佳,曹蓓.加味痛泻要方治疗肠易激综合征41例[J].中医中药,2007,4(8)：120.
[32]吴玉泓.柴胡桂枝汤加味治疗腹泻型肠易激综合征体会[J].中国中医药信息杂志,2008,15(12)：86.
[33]张艳国, 佟秀芳,郑素梅,等. 通络安肠饮治疗腹泻型肠易激综合征130例临床观察[J].河北中医,2009,31(9)：1314.
[34]郑卫方,吴胜智,胡佩玲,等.温阳疏肝调肠汤治疗腹泻主导型肠易激综合征46例[J].浙江中医杂志,2009,44(3)：198.
[35]罗毅.便秘型肠易激综合征的辨治体会[J].辽宁中医学院学报,2006,8(3).
[36]阙立明.加味六磨汤治疗便秘型肠易激综合征临床观察[J].实用中医内科杂志,2008,22(12)：31.
[37]陈笑腾.马伟明辨治肠易激综合征的经验[J].浙江中医杂志,2009,44(9)：637.
[38]陈志斌,谭武.俞募配穴埋线法治疗肠易激综合征90例[J].中医研究,2009,22(4)：52.
[39]李伟.温针灸结合脊柱推拿治疗肠易激综合征[J].中国实用医药,2009,4(31)：212.
[40]赵学田,曾宏翔,李兆文,等.针灸单穴治疗腹泻型肠易激综合征的临床研究[J].中医药通报,2009,8(4)：63-64.
[41]陈朝元,何顺勇,郑琳,等.加味痛泻要方治疗腹泻型肠易激综合征30例临床观察[J].福建中医学院学报,2009,19(5)：1-3.
[2]刘志新.黄金刚, 《黄帝内经》与脾胃学说[J].黑龙江中医药,2010.4(4)：49-50.
[3]王喆.高慧霞.《伤寒论》顾护脾胃学术思想浅析[J].山西中医学院学报.2010.11(4)：7-8.
[4]郎世平.唐犀麟.《伤寒论》脾胃病证治探讨[J].中国实用医药.2009.4(16)：243-244.
[5]刘晖.《伤寒论》脾胃学说浅识[J].甘肃中医学院学报.2004.21(1)：15-16.
[6]曹洋.《伤寒论》重视脾胃的学术思想探析[J].内蒙古中医药.2008.6(1)：58-59.
[7]夏军权.仲景脾胃学说临证启迪[J].辽宁中医药大学学报.2011.13(3)：14-15.
[8]杨小红,顾武军.论顾护脾胃在仲景学术思想中的重要地位.辽宁中报,2004,6(6)：443-444
[9]王剑发,宋炳礼.李东垣“脾升胃降”学术思想阐析.辽宁中医学院学报,2006,8(2)34-35
[10]董振华.李东垣对脾胃学说的贡献.现代远程教育,2005,3(11)：19-21
[11]徐寿生.李果脾胃阴阳升降理论探讨.安徽中医学院学报,1999,18(4)：9-10
[12]李赛美.从《脾胃论》看东垣对仲景学说的继承与发展.广州中医药大学学报,2007,24(1)：76-77
[13]王改仙.郭志伟.从《脾胃论》谈药后调理.中国民间疗法,2011,19(7)：61
[14]危北海.脾胃学说的形成.山东中睦学院学报,1983,7(4)：58-60
[15]宇文亚.孙思邈治疗脾胃病理论与方药探讨.辽宁中医杂志,2007,34(6)：738-739
[16]栾胜军.学习医家张元素的体会.中国现代药物应用,2008,2(13)：109-110
[17]翟玉民.张元素学术思想浅探.中医临床研究,2010,2(5)：122-123
[18]韩向东.赵莉.薛己《内科摘要》学术思想探析.辽宁中医学院学报,2005,7(4)：351-352
[19]唐伟华.孙世发.景岳方剂用药规律研究.山西中医药学报,2010,38(4)：53-54
[20]张晶.张宗明.张景岳“五脏体用养阴法”探析.甘肃中医,2008,21(10)：3-4
[21]徐晓东.李中梓治泻九法.吉林中医药,2009,29(12)：1098
[22]王维.李中梓泄泻学术思想探析.中医研究,2005,18(5)：61-62
[23]郑星.叶天士胃阴学说探析.上海中医药杂志,2002,12：34-35
[24]黄英志主编.叶天士医学全书.中国中医药出版社,1999,85-87
[1]Talley NJ.The functional gastrointestinal disorders and the Rome Ⅱ process Gut[J].1999, 45(Suppl Ⅱ):111-115
[2]Dressan DA.Richter JE, Talley NJ, et al.The functional Gastrointestinal Disorders[J].Boston:little Brown & Co,1994,1-74
[3]李瑜.精神心理异常与功能性胃肠疾病的关系[J].中华医学杂志,1999,79(10)：799～780
[4]周福生,张庆宏,黄志新,等.胃肠功能性疾病中医疗效评价与生存质量关系初探[J].中国中西医结合杂志。2001。21(10)：738.
[5]吴敦序.中医基础理论[M].上海：上海科技出版社,1995,42
[6]刘淑新.论“正气存内,邪不可干”及其在临床上的意义[J].中医函授通讯,1994,(6)：24
[7]中华消化学会胃肠动力学组.我国慢性便秘的诊治指南[J].中国全科医学,2005,8(2)：119-121
[8]刘建新,邱国海,傅志雄.四逆散加味合替加色罗治疗便秘型肠易激综合征的临床研究[J].中医药学刊,2006,24(8)：1460-1461.
[9]陈锦辉.白术润肠汤治疗便秘型肠易激综合征71例[J].新中医,2005,37(10)：76.
[10]学宝,胡玲.枳术汤加减治疗便秘型肠易激综合征39例[J].新中医,2003,35(6)：63-64.
[11]吴学琴,四磨汤加西沙比利治疗便秘型肠易激综合征28例[J].河北医药,2003,25(3)：203.
[12]莫滚,何焕平.健脾理肠汤治疗便秘型肠易激综合征96例[J].中国中西医结合消化杂志,2008,16(3)：206-207.
[13]高强,李慧臻.宣肺理气活血法治疗便秘型肠易激综38例[J].吉林中医药,2007,27(12)： 25-26.
[14]赵黎.便秘型肠易激综合征从毒论治[J].新中医,2009,41(11)：119.
[15]王奎平.疏肝理气润肠治疗IBS-C[J]浙江中医杂志,2004：39(1)：125.
[16]李富增.加昧麻仁润肠丸治疗便秘型肠易激综合征40例[J].山西中医,2004；20(3)：36.
[17]柳梅.益肾平肝祛瘀治疗便秘型肠易激综合症57例[J].河北中医,2004；26
[18]林群莲,黄复盛.宣肺调气法治疗IBS-C36例[J].福建中医药,2002；33(4)：23-24.
[19]张蜀,吴至久,廖伯年.逍遥散加味治疗便秘型肠易激综合征27例[J].实用中医内科杂志,2008,22(3)：31.
[20]阙立明.加味六磨汤治疗便秘型肠易激综合征临床观察[J].实用中医内科杂志,2008,22(12)：31.
[21]张家炎.疏肝健脾法治疗便秘型肠易激综合征的临床疗效分析[J].甘肃中医,2009,22(7)：23-24.
[22]高强,李慧臻.宣肺理气活血法治疗便秘型肠易激综合征38例[J].吉林中医药,2007,27(12)：25-26.
[23]王长来.养血通腑汤治疗肠易激综合征便秘型50例[J].江西中医药,2008,39(303)：21.
[24]吕永慧,汪运鹏.通幽清治疗便秘型肠易激综合征疗效观察[J],中国中药杂志[J],2008,33(6)：691-693.
[25]刘谦民,令狐恩强,刘运详.主编.功能性胃肠病学.第一版.北京：人民军医出版社2003：45.
[26]李延青,杨云生,陈建.肠易激综合征[M].北京：中国医药科技出版社,2005：44-46.
[27]中华医学会消化病学分会.中国慢性胃炎共识[J].现代消化及介入诊疗,2007,12(1)：55-62.
[28]张万岱,陈治水,危北海,《慢性胃炎的中西医结合诊治方案》,世界华人消化杂志,2004；12(11)：2697-2700
[29]危北海,《中西医结合消化病学》,人民卫生出版社
[30]苏娟萍,冯五金,肠必安灌肠治疗溃疡性结肠炎的临床研究,山西中医学院学报,20067(3)：30-31
[31]贾志新,冯五金,肠必安对乙酸刺激法致大鼠溃疡性结肠炎的实验研究,山西中医学院学报20056(2)：45-46
[32]苏娟萍,冯五金,肠必安灌肠治疗溃疡性结肠炎36例临床分析,山西中医学院学报20045(4)：12-13
[33]贾志新, 冯五金,肠必安治疗免疫致敏法致大鼠溃疡性结肠炎的实验研究,2005,中国中西医结合学会第十七次全国消化系统疾病学术研讨会
[34]贾慧,溃疡性结肠炎辨治体会,中外健康文摘2008,3(5)113-114
[35]董秀娟,邱向红,唐梁,溃疡性结肠炎中医药治疗进展,北京中医药大学学报(中医临床版)2007,14(4)：44-46
[36]吴彩娥；伍永娟；潘文姣；程清琳；中药二步灌肠治疗溃疡性结肠炎30例,河北中医2002, (9)
[37]单兆伟,刘沈林,黄俊著.内科多发病中西医综合治疗,北京：人民卫生出版社
[38]张福奎,功能性消化不良的研究进展,中国医刊,2003,8(9)：27-28
[39]莫剑忠,袁耀宗,邹多武主编,消化系功能性和动力障碍性疾病,上海：上海科学技术出版社,2005,7
[40]马汴梁主编,中西医结合胃肠病学,北京中医古籍出版社,1993.4
[41]刘文,张大伟,中药对胃肠运动功能的影响,中国中西医结合脾胃杂志,1998,6(5)：192
[42]陈露,功能性消化不良的病因研究进展[J],临床消化病杂志,2003,15(4)：187-189
[43]潘志恒,曹世植,现代胃肠病学[M],北京：科学出版社,1998,854-855
[44]刘群,中医治疗功能性消化不良的进展, 中成药,2002,24(7)：541-3
[45]萧树东,开展对功能性消化不良的研究[J],中华消化杂志,1994,14(5)：249
[1]复旦大学上海医学院.实用内科学第12版[M].人民卫生出版社,2006年.
[2]叶任高,陆再英.内科学[M].人民卫生出版社,2004,2月第6版.
[3]李延青.肠易激综合征[J].中国医药科技出版社,2005,7(1).
[4]宗春华.肠易激综合征manning诊断标准的评价[J].上海第二军医大学学报,2004,117-119.
[5]功能性胃肠疾病的诊断标准-Rome2标准[J].临床内科学杂志,2000,17(2)：27-129.
[6]张正利.肠易激综合征中医论治溯源[J].中国中医基础医学杂志,2001,7(7)：48-50.
[7]葛恒松.辨证分型治疗肠易激综合征62例[J].陕西中医,1998,19(7)：331.
[8]周向阳,王世勋,王荣林.四逆散为主辨证治疗肠易激综合征120例[J].国医论坛,1999,14(1)：8.
[9]申亚东,张峰.加味逍遥散治疗腹泻型肠易激综合征45例[J].河南中医药学刊,2000,15(6)：37.
[10]徐佩华,缪平,应丹松.平肝健脾法治疗肠易激综合征38例[J].实用中医药杂志,1999,15(1)：17.
[11]刘保成.从肝气阳虚论治肠易激综合征临床研究[J].中国中西医结合消化杂志,2001,9(3)：71.
[12]朱耀群,陈军贤,李军.补中益气汤加减治疗肠易激综合征89例疗效观察[J].实用医学杂志,1996,12(6)：399.
[13]范京国,周东民.缓急汤治疗腹泻型肠易激综合征42例[J].实用中医药杂志,2001,17(11)：7.
[14]于宁.从肺论治肠易激综合征的理论文献研究[D].北京中医药大学,2011.
[15]董晓明.温肾健脾法治疗肠易激综合征82例.浙江中医学院学报,1999,23(1)：36
[16]孙为宏,兰著玲.中西医结合治疗肠道激惹综合征[J].实用中医药杂志,1999,15(8)：34.
[17]戈力.自拟愈泻汤治疗肠易激综合征32例临床体会[J].甘肃中医,2000,13(1)：25-26.
[18]郭汉卿.从风论治肠易激综合征探析[J].实用中医内科杂志,2002,16(4)：17.
[19]类承法,初立志.从痰论治肠易激综合征48例[J].山东中医杂志,2000,19(4)：206.
[20]陈伟红.自拟安肠汤治疗肠易激综合征39例[J].广西中医药,1999,22(4)：8.
[21]张艳国.血府逐瘀汤加味治疗肠易激综合征65例[J].河北中医药学报,2001,16(2)：18.
[22]郑荣辉.理气活血法治疗肠易激综合征47例[J].浙江中西医结合杂志,2003,13(5)：297.
[23]汪静凤,刘煜.抑肝扶脾化痰祛癖法治疗肠易激综合征36例[J].南京中医药大学学报,2000,16(4)：250.
[24]张华,蝎亚萍,蒙雅群.肠易激综合征辨证施治体会[J].陕西中医学院学报,2002,25(5)：20-21.
[25]刘勇,潘明义.辨证分型治疗肠易激综合征30例[J].山东中医杂志,2000,19(6)：348.
[26]沈明,刘杰.中西医结合治疗肠易激综合征40例[J].中西医结合内科杂志,1998,11(12)：1090.
[27]张淑娥,张希全.参苓白术散加味治疗肠易激综合征52例[J].陕西中医,1998,19(7)：312.
[28]刘力,沈舒文.肠易激综合征中医辨证论治[J].实用中医内科杂志,2002,16(3)：157-158.
[29]谢广仁.肠易激综合征辨治方法探讨[J].陕西中医,1999,20(9)：404.
[30]任赞屹.中西医结合治疗肠易激综合征86例疗效观察[J].河南中医学院学报,2004,19(6)：58.
[31]黄穗平,梁乃津.从肝论治肠易激综合征经验[J].新中医,1996,28(5)：9.
[32]李剑锋.肠易激综合征辨证分析[J].2008,3(3)：165-166.
[33]李振彬.周仲瑛教授治疗肠易激综合征的经验[J].新中医,1997,29(8)：6.
[34]吴成胜.从肝脾论治腹泻型肠易激综合征探微[J].山东中医药大学学报,2004,28(1)：45.
[35]李一新.电针加耳穴治疗肠易激综合征21例[J].针灸临床杂志,2002,18(2)：29.
[36]敖学艳,王宁.耳压点穴按摩治疗肠易激综合征60例[J].针灸临床杂志,2002,18(3)：36.
[37]徐运瑜.背部走罐治疗肠易激综合征48例[J].浙江中医杂志,2007,42(3)：163.
[38]钟文元.足反射法结合腹部按摩法治疗肠易激综合征疗效观察[J].双足与保健,2000,(4)：61.
[39]黄政德.针刺推拿结合治疗肠易激综合征[J].中国针灸,2006,26(10)：717-718.
[1]李瑜.精神心理异常与功能性胃肠疾病的关系[J].中华医学杂志,1999,79(10)：799～780
[2]周福生,张庆宏,黄志新,等.胃肠功能性疾病中医疗效评价与生存质量关系初探[J].中国中西医结合杂志。2001。21(10)：738.
[3]潘国宗,鲁素彩,柯美云,等.北京地区肠易激综合征的流行病学研究：一个整群、分层、随机调查[J].中华流行病学杂志,2000,21：26-29.
[4]申亚东,张峰.加味逍遥散治疗腹泻型肠易激综合征85例[J].河南中医药学刊,2000,15(6)：37.
[5]朱文锋.中医诊断学[M].北京：中国中医药出版社,2002,2：235
[6]朱文锋.证素辨证学[M].北京：人民卫生出版社,2008：：88-159
[7]黄碧群,朱镇华.证素等概念的辨析中华中医药杂志[J].2005,20(5)：273
[8]孙振球.医学统计学[M].北京：人民卫生出版社,2002
[9]金丕焕.医用统计方法[M].上海：复旦大学出版社,2002
[10]吴敦序.中医基础理论[M].上海：上海科技出版社,1995,42
[11]Chang FY, Lu C I. Irritable bowel syndrome in the 21st century:perspectives from Asia or South-east Asia[J]. J Gastroenterol Hepatol,2007,22(1):4-12.
[12]Vandvik P O, Lydersen S, Farup P G. PrevMence, comorbidit and impact of irritable bowel syndrome in Norway [J]. Scand Gastroenterol.2006,41(4):650-656.
[13]Schmulson M, Ortiz O, Santiago-Lomeli M, et al. Frequency of functional bowel disorders among healthy volunteers in Mexico City [J]. Dig Dis,2006,24(3-4): 342-347.
[14]熊理守,陈曼湖,陈惠新,等.广东省社区人群肠易激综合征的流行病学研究[J].中华医学杂志,2004,84：278-228.
[15]Drossman D A. The functional gastrointestinal disorders and the RomeⅢ process[J]. Gastroenterology,2006,130(5):1377-1390.
[16]Levy R L, Jones K R, Whitehead W E, et al. Irritable bowel syndrome in twins:heredity and social learning both contribute to etiology[J]. Gastroenterology,2001,121(4): 799-804.
[17]Tornblom H, Lindberg G, Nvberq B. et al. Full-thickness biopsy of the jejunum reveals inflammation and enteric neuropathy in irritable bowel syndrome [J]. Gastroenterology, 2002,123(6):1972-1979.
[18]王伟岸,钱家鸣,潘国宗.结肠黏膜肥大细胞活化在肠易激综合征发病中的作用[J].中华消化杂志,2003,23(5)：263-266.
[19]潘国宗.肠道感染在肠易激综合征发病中的作用[J].胃肠病学,2006,11(6)：321-322.
[20]De Ponti F, Tonini M. Irritable bowel syndrome:new agents targeting serutonin receptor subtypes[J]. Drugs,2001,61(3):317-332.
[21]张希全.思密达与洛哌丁胺对腹泻型肠易激综合征疗效的比较研究[J].中国临床药理学杂志,2000,16(1)：25-26.
[22]莫文辉,郭传勇.微生态制剂在肠易激综合征中的临床应用及评价[J].世界临床药物,2008,29(12)：722-724.
[23]朱耀群,陈军贤,李军.补中益气汤加减治疗肠易激综合征89例临床疗效观察[J].实用医学杂志,1996,12(6)：399.
[24]范京国,周东民.缓急汤治疗腹泻型肠易激综合征42例[J].实用中医药杂志,2001,17(11)：7.
[25]原培谦.辨证治疗肠易激综合征76例[J].北京中医药大学学报(中医临床版),2007,14(2)：14-15.
[26]吴华清,姚保泰.肠易激综合征辨治[J].山东中医杂志,2007,26(6)：393-394.
[27]王伟伟.肠易激综合征的中医诊治浅探[J].浙江中西医结合杂志,2009,19(9)：552.
[28]彭林.辨证分型治疗泄泻型肠易激综合征58例[J].江西中医药,2005,36(6)：27-28.
[29]汪运鹏,吕永慧.便秘型肠易激综合征病因病机及治疗研究进展[J].现代消化及介入治疗,2007,12(2)：128.
[30]刘万里.肠易激综合征62例临床观察[J].江苏中医药,2009,41(8)：35.
[31]吴莉佳,曹蓓.加味痛泻要方治疗肠易激综合征41例[J].中医中药,2007,4(8)：120.
[32]吴玉泓.柴胡桂枝汤加味治疗腹泻型肠易激综合征体会[J].中国中医药信息杂志,2008,15(12)：86.
[33]张艳国, 佟秀芳,郑素梅,等. 通络安肠饮治疗腹泻型肠易激综合征130例临床观察[J].河北中医,2009,31(9)：1314.
[34]郑卫方,吴胜智,胡佩玲,等.温阳疏肝调肠汤治疗腹泻主导型肠易激综合征46例[J].浙江中医杂志,2009,44(3)：198.
[35]罗毅.便秘型肠易激综合征的辨治体会[J].辽宁中医学院学报,2006,8(3).
[36]阙立明.加味六磨汤治疗便秘型肠易激综合征临床观察[J].实用中医内科杂志,2008,22(12)：31.
[37]陈笑腾.马伟明辨治肠易激综合征的经验[J].浙江中医杂志,2009,44(9)：637.
[38]陈志斌,谭武.俞募配穴埋线法治疗肠易激综合征90例[J].中医研究,2009,22(4)：52.
[39]李伟.温针灸结合脊柱推拿治疗肠易激综合征[J].中国实用医药,2009,4(31)：212.
[40]赵学田,曾宏翔,李兆文,等.针灸单穴治疗腹泻型肠易激综合征的临床研究[J].中医药通报,2009,8(4)：63-64.
[41]陈朝元,何顺勇,郑琳,等.加味痛泻要方治疗腹泻型肠易激综合征30例临床观察[J].福建中医学院学报,2009,19(5)：1-3.