基于“肝病实脾”理论探讨小建中汤治疗肝病脾虚证
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摘要
"肝病实脾"即见肝之病,应当知肝病最易传脾,所以在治疗时不但要治肝,而且"当先实脾",即首先顾全脾胃的调治。临床上运用小建中汤治疗肝病(脾虚证)得到很好的效果,动物实验研究也证实小建中汤对脾虚证有明确的治疗意义。通过总结分析相关文献,从小建中汤治疗脾胃虚弱证的作用机制出发,探讨其在肝病(脾虚证)上的运用。
"Treating liver by nourishing spleen" is mean that when the liver is diseased, the spleen is the first to be affected, so not only the liver should be treated in the treatment, but also nourishing spleen namely the treatment of the spleen and stomach at first. The clinical application of Xiao jianzhong decoction in the treatment of liver disease(spleen deficiency) to obtain good results, and the animal experiments have demonstrated that Xiao Jianzhong decoction has definite significance for the treatment of spleen deficiency syndrome. This paper summarizes the relevant literature,starting from the mechanism of the treatment of spleen deficiency by Xiao Jianzhong decoction and to explore Xiao Jianzhong decoction's application on liver disease(spleen deficiency).
"Treating liver by nourishing spleen" is mean that when the liver is diseased, the spleen is the first to be affected, so not only the liver should be treated in the treatment, but also nourishing spleen namely the treatment of the spleen and stomach at first. The clinical application of Xiao jianzhong decoction in the treatment of liver disease(spleen deficiency) to obtain good results, and the animal experiments have demonstrated that Xiao Jianzhong decoction has definite significance for the treatment of spleen deficiency syndrome. This paper summarizes the relevant literature,starting from the mechanism of the treatment of spleen deficiency by Xiao Jianzhong decoction and to explore Xiao Jianzhong decoction's application on liver disease(spleen deficiency).
引文
[1]赵沁慧,王文广,晁利芹,等.“浅谈肝病实脾”[J].辽宁中医杂志,2014,41(8):1617-1618.
[2]蔡行平.肝病缠绵治脾为先[J].中医药学刊,2006,24(4):708-709.
[3]张锡纯.医学衷中参西录[M].石家庄:河北人民出版社,1957:122.
[4]霍莉莉,虞坚尔.治肝实脾浅诠[J].上海中医药杂志,2006,40(2):45.
[5]董襄国,朱古亭.学习《金匮要略》谈“治肝实脾法”[J].浙江中医学院学报,1982(3):42-45.
[6]赵会聪,宋文宇,张正利.小建中汤病机新解[J].吉林中医药,2014,34(6):553-555.
[7]曹颖甫.金匮发微[M].北京:学苑出版社,2008:60,149.
[8]黄煌.经方的魅力[M].北京:人民卫生出版社,2006:138-139.
[9]刘光伟,王灵台.慢性乙型肝炎免疫病理及中医药免疫调节治疗研究概况[J].上海中医药大学学报,2005,19(1):59-61.
[10]张吉兰.加味小建中汤治疗乙型肝炎临床体会[J].中国医刊,1990,25(6):59-60.
[11]刘红书,邵宁.小建中汤治疗慢性乙型病毒性肝炎合并胃黏膜病变[J].山东中医杂志,1999(5):211.
[12]陈宁勇,王海宁.小建中汤加味治疗慢性乙型肝炎68例[J].国医论坛,1992(3):14.
[13]陶志广.桂枝汤类方在肝癌治疗中的价值初探[J].四川中医杂志,2007,25(10):125-126.
[14]李开韵,邵雷.从“治未病”思想浅论小建中汤治疗肝病[J].中医学报,2014,29(12):1743-1744.
[15]陈明.伤寒名医验案精选[M].北京:学苑出版社,1998:135-136.
[16]黄煌.张仲景50味药证[M].北京:人民卫生出版社,2012:20.
[17]刘茜,周永学,王斌,等.小建中汤对脾胃虚寒大鼠IL-6、GAS水平的影响[J].陕西中医,2011,32(3):368-369.
[18]周永学,刘茜,王斌.小建中汤抗脾胃虚寒大鼠脂质过氧化损伤及环核苷酸水平紊乱的研究[J].中国实验方剂学杂志,2011,17(23):151-154.
[19]孙宁,刘旺根,王雪萍,等.黄芪建中汤对脾虚型慢性萎缩性胃炎大鼠胃黏膜病理形态影响的研究[J].河南中医学院学报,2005,20(5):11-12.
[20]陶玲,史琴,沈祥春.小建中汤有无饴糖对实验性小鼠脾虚模型的作用研究[J].中药药理与临床,2008,24(6):12-14.
[21]王红伟,刘旺根,丁瑞敏.黄芪建中汤对脾虚大鼠血液成分及细胞免疫功能的影响[J].河南中医药学刊,2002,17(6):16-17.
[22]高丽松,曾凡潘,宁榴贤,等.处理党参药液对小白鼠碳粒廓清功能影响的研究[J].生物磁学,2004,4(4):1-4.
[23]徐世军,代渊,张三印,等.益气增液颗粒对脾虚SD大鼠胃肠黏膜分泌及免疫功能影响的初步研究[J].中药药理与临床,2004,20(1):20-21.
[24]史振国,王学武.小建中汤联合西药治疗脾胃虚寒型PU的效果及对血清、胃液EGF与胃黏膜EGFR的影响研究[J].世界中西医结合杂志.2016(05).
[25]李震,宋慧平,张浩,等.小建中汤配伍不同糖类方对胃溃疡模型小鼠预防的比较研究[J].山东中医药大学报,2016,40(6):573-575,592.
[26]宋红,郑小伟,王颖,等.加味黄芪建中汤对脾气虚证大鼠胃泌素基因表达的影响[J].中华中医药杂志,2008,23(2):121-122.
[27]李伟林.慢性乙型肝炎脾虚证临床病理学分析[J].中西医结合肝病杂志,1994,4(增刊):63.
[2]蔡行平.肝病缠绵治脾为先[J].中医药学刊,2006,24(4):708-709.
[3]张锡纯.医学衷中参西录[M].石家庄:河北人民出版社,1957:122.
[4]霍莉莉,虞坚尔.治肝实脾浅诠[J].上海中医药杂志,2006,40(2):45.
[5]董襄国,朱古亭.学习《金匮要略》谈“治肝实脾法”[J].浙江中医学院学报,1982(3):42-45.
[6]赵会聪,宋文宇,张正利.小建中汤病机新解[J].吉林中医药,2014,34(6):553-555.
[7]曹颖甫.金匮发微[M].北京:学苑出版社,2008:60,149.
[8]黄煌.经方的魅力[M].北京:人民卫生出版社,2006:138-139.
[9]刘光伟,王灵台.慢性乙型肝炎免疫病理及中医药免疫调节治疗研究概况[J].上海中医药大学学报,2005,19(1):59-61.
[10]张吉兰.加味小建中汤治疗乙型肝炎临床体会[J].中国医刊,1990,25(6):59-60.
[11]刘红书,邵宁.小建中汤治疗慢性乙型病毒性肝炎合并胃黏膜病变[J].山东中医杂志,1999(5):211.
[12]陈宁勇,王海宁.小建中汤加味治疗慢性乙型肝炎68例[J].国医论坛,1992(3):14.
[13]陶志广.桂枝汤类方在肝癌治疗中的价值初探[J].四川中医杂志,2007,25(10):125-126.
[14]李开韵,邵雷.从“治未病”思想浅论小建中汤治疗肝病[J].中医学报,2014,29(12):1743-1744.
[15]陈明.伤寒名医验案精选[M].北京:学苑出版社,1998:135-136.
[16]黄煌.张仲景50味药证[M].北京:人民卫生出版社,2012:20.
[17]刘茜,周永学,王斌,等.小建中汤对脾胃虚寒大鼠IL-6、GAS水平的影响[J].陕西中医,2011,32(3):368-369.
[18]周永学,刘茜,王斌.小建中汤抗脾胃虚寒大鼠脂质过氧化损伤及环核苷酸水平紊乱的研究[J].中国实验方剂学杂志,2011,17(23):151-154.
[19]孙宁,刘旺根,王雪萍,等.黄芪建中汤对脾虚型慢性萎缩性胃炎大鼠胃黏膜病理形态影响的研究[J].河南中医学院学报,2005,20(5):11-12.
[20]陶玲,史琴,沈祥春.小建中汤有无饴糖对实验性小鼠脾虚模型的作用研究[J].中药药理与临床,2008,24(6):12-14.
[21]王红伟,刘旺根,丁瑞敏.黄芪建中汤对脾虚大鼠血液成分及细胞免疫功能的影响[J].河南中医药学刊,2002,17(6):16-17.
[22]高丽松,曾凡潘,宁榴贤,等.处理党参药液对小白鼠碳粒廓清功能影响的研究[J].生物磁学,2004,4(4):1-4.
[23]徐世军,代渊,张三印,等.益气增液颗粒对脾虚SD大鼠胃肠黏膜分泌及免疫功能影响的初步研究[J].中药药理与临床,2004,20(1):20-21.
[24]史振国,王学武.小建中汤联合西药治疗脾胃虚寒型PU的效果及对血清、胃液EGF与胃黏膜EGFR的影响研究[J].世界中西医结合杂志.2016(05).
[25]李震,宋慧平,张浩,等.小建中汤配伍不同糖类方对胃溃疡模型小鼠预防的比较研究[J].山东中医药大学报,2016,40(6):573-575,592.
[26]宋红,郑小伟,王颖,等.加味黄芪建中汤对脾气虚证大鼠胃泌素基因表达的影响[J].中华中医药杂志,2008,23(2):121-122.
[27]李伟林.慢性乙型肝炎脾虚证临床病理学分析[J].中西医结合肝病杂志,1994,4(增刊):63.