[1]张 景,曾禹沙,李婧婧,等.从络病探析功能性肛门直肠痛[J].陕西中医,2024,(10):1386-1390.[doi:DOI:10.3969/j.issn.1000-7369.2024.10.020]
　ZHANG Jing,ZENG Yusha,LI Jingjing,et al.Analysis of functional anorectal pain based on collateral disease[J].,2024,(10):1386-1390.[doi:DOI:10.3969/j.issn.1000-7369.2024.10.020]
点击复制

从络病探析功能性肛门直肠痛
分享到：

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2024年10期
页码:
1386-1390
栏目:
学术探讨
出版日期:
2024-10-05

文章信息/Info

Title:
Analysis of functional anorectal pain based on collateral disease
作者:
张 景1; 曾禹沙1; 李婧婧1; 许新意1; 朱沁兵1; 刘辰圆1; 田 珂1; 薛雅红2
(1.南京中医药大学研究生院,江苏 南京 210023; 2.南京中医药大学附属南京中医院,江苏 南京 210006)
Author(s):
ZHANG Jing; ZENG Yusha; LI Jingjing; XU Xinyi; ZHU Qinbing; LIU Chenyuan; TIAN Ke; XUE Yahong
(Graduate School of Nanjing University of Chinese Medicine,Nanjing 210023,China)
关键词:
络病学说;  功能性肛门直肠痛;  疼痛;  脑-肠轴;  络脉绌急;  升降散
Keywords:
Collateral disease theory;  Functional anorectal pain;  Pain;  Brain-gut axis;  Collateral stagnation and urgency;  Shengjiang powder
分类号:
R 657.1
DOI:
DOI:10.3969/j.issn.1000-7369.2024.10.020
文献标志码:
A
摘要:
络病广泛存在于各类外感重症及内伤疑难杂病之中,功能性肛门直肠痛作为肛肠科非器质性难治性疾病,往往缠绵难愈,给患者的身心健康以及日常生活带来极大困扰,其契合络病“久病入络”的病程演变规律。现代医学认为其主要与肠-脑互动异常、盆腔神经肌肉功能紊乱、精神心理等因素相关。本文重点阐述从络病论治功能性肛门直肠痛的理论,认为本病的病位在肠络,络中气血升降失常,清阳浊阴交争导致络脉绌急是本病发生的关键。对于功能性肛门直肠痛的治疗策略应当以复通络脉中气血升降有序为着眼点,病在局部而治在整体,采用补虚以荣络、辛温以通络、祛瘀以通络、藤虫以搜络等法,充分展现中医辨证论治以及络病学说的特色,以期对临床诊疗提供进一步导向。
Abstract:
Collateral disease is widely presented in various types of severe external infections and complex internal injuries.Functional anorectal pain, as a non-organic and intractable disease in the field of proctology, is lingering and difficult to heal, affecting their physical and mental health as well as daily life.It conforms to the evolutionary law of the disease course of “prolonged illness entering the collateral”.Modern medicine believes that it is mainly related to abnormal gut-brain interaction, pelvic neuromuscular dysfunction,psychological and other factors.This article focuses on the theory of treating functional anorectal pain from the perspective of collateral diseases.The location of this disease is in the intestinal collateral.It is deemed that the key to the occurrence of this disease is the abnormal rise and fall of Qi and Blood in the collaterals, and the conflict between clear Yang and turbid Yin which leads to the stagnation and urgency of the collaterals.The treatment should pay attention to restore the orderly rise and fall of Qi and Blood in the collaterals.In addition, the disease should be treated locally with a holistic approach, employing methods such as Buxu Rongluo, Xinwen Tongluo, Quyu Tongluo, Tengchong Souluo.It will fully reflect the characteristics of collateral disease theory based on traditional Chinese medicine syndrome differentiation and treatment, with the aim of providing further guidance for clinical treatment.

参考文献/References:

[1] BHARUCHA A E,LEE T H.Anorectal and pelvic pain[J].Mayo Clin Proc,2016,91(10):1471-1486.
[2] 方秀才,侯晓华.罗马Ⅳ功能性胃肠病肠-脑互动异常[M].北京:科学出版社,2016:814-818.
[3] 尹万斌,周聪,王帅.功能性肛门直肠痛的病理机制研究进展[J].中国肛肠病杂志,2022,42(12):61-63.
[4] KNOWLES C H,COHEN R C.Chronic anal pain:A review of causes,diagnosis,and treatment[J].Cleve Clin J Med,2022,89(6):336-343.
[5] 孙雨晴,郑雪平.中医药治疗功能性肛门直肠痛的研究进展[J].中国民间疗法,2020,28(23):115-117.
[6] 马玉草,吕柳,胡杰,等.基于络病理论探讨干燥综合征的病机与治疗[J].陕西中医,2023,44(4):479-482.
[7] 吴以岭.络病学[M].北京:中国中医药出版社,2017:21-57.
[8] 赵进喜,贾海忠,张书信,等.通法治百病,魄门为五脏使; 从脏腑论治,肛肠诸疾可安[J].环球中医药,2022,15(12):2408-2412.
[9] BYRNES K G,SAHEBALLY S M,MCCAWLEY N,et al.Optimal management of functional anorectal pain:A systematic review and network meta-analysis[J].Eur J Gastroenterol Hepatol,2022,34(3):249-259.
[10] 付仲田,杨俏田.疼痛理论与通络学说[J].中西医结合心脑血管病杂志,2009,7(8):953-954.
[11] 梁勇,高原,葛斌,等.从“郁”论治功能性肛门直肠痛经验[J].中国中医急症,2021,30(11):2049-2051.
[12] 胡露楠,刘启鸿,柯晓.“脑肠同调”治法在功能性便秘中的运用[J].实用中医内科杂志,2023,37(12):56-59.
[13] 杨希平.谷道宜常撮[J].家庭医药,2009,9(10):64.
[14] 孙文军,唐启盛.张锡纯思想中的心脑相通理论[J].中华中医药杂志,2011,26(3):427-429.
[15] 王雅娴,王业皇,吴燕兰.王业皇辨治功能性肛门直肠痛的经验撷英[J].时珍国医国药,2019,30(9):2248-2249.
[16] 郑春菊,王业皇.从肝论治功能性肛门直肠痛的探讨[J].河北中医,2014,36(10):1555-1556.
[17] 李紫健,牛建海,孟惠改,等.李东垣“脾胃虚则九窍不通论”对《内经》的继承与发展[J].中国民族民间医药,2017,26(19):1-3.
[18] 张娇娇,丁义江,丁曙晴,等.功能性肛门直肠痛中医证型研究[J].辽宁中医药大学学报,2018,20(6):107-109.
[19] 王斯涵,庞立健,刘创,等.络虚不荣,邪气瘀阻——慢性疼痛中医共性核心病机发微[J].辽宁中医杂志,2017,44(10):2065-2067.
[20] 刘艳妮,江滨,章阳,等.益气养血汤治疗功能性肛门直肠痛临床疗效观察[J].天津中医药大学学报,2020,39(4):429-432.
[21] 李时珍.本草纲目[M].北京:人民卫生出版社,2005:927.
[22] 李佳楠,张书信,郁强,等.从瘀论治功能性肛门直肠痛[J].中国中医药信息杂志,2022,29(1):140-142.
[23] 李月,王业皇.王业皇运用风药治疗功能性肛门直肠痛经验拾粹[J].江苏中医药,2019,51(1):25-27.
[24] 叶天士.临证指南医案[M].北京:人民卫生出版社,2006:178.
[25] 马珂珂,李月,王贝贝,等.王业皇运用虫类药治疗功能性肛门直肠痛经验[J].山东中医杂志,2022,41(5):548-551.
[26] 赵志强,王超,赵婉琳,等.温阳通络法治疗功能性肛门直肠痛疗效研究[J].陕西中医,2022,43(9):1246-1248.
[27] 任雪童,狄紫蕊,张哲,等.李佃贵基于浊毒理论对升降散的新旨发微[J].世界中西医结合杂志,2020,15(8):1426-1430.
[28] 杨泽,陈佳丽,汪翔,等.清浊相干理论探微[J].新中医,2021,53(17):202-205.
[29] 刘福贵,丁瑞丛,彭超群,等.升降散源流考辨及临床运用[J].中国中医基础医学杂志,2021,27(11):1799-1801,1827.
[30] 杜昕,冯奇,檀金川,等.升降散研究进展[J].天津中医药,2019,36(5):516-520.
[31] 中国中医研究院.蒲辅周医疗经验[M].北京:人民卫生出版社,2005:41.
[32] 郭文杰,袁智宇.升降散内科临床应用概述[J].中国民间疗法,2021,29(23):132-136.
[33] 赵雪莹,赵玺宣.从“火郁发之”理论探析升降散之临床应用及其拓展[J].环球中医药,2022,15(9):1574-1577.
[34] 黄丹卉.赵绍琴温病学术思想在内伤杂病中的运用研究[D].北京:北京中医药大学,2013.
[35] 刘文军.薛伯寿教授应用升降散方证规律及临床传承研究[D].北京:中国中医科学院,2013.
[36] 董若曦,王敏,陆金根,等.芍药甘草汤加甘麦大枣汤联合生物反馈治疗老年功能性肛门直肠痛的临床观察[J].老年医学与保健,2021,27(2):343-347.
[37] 易思彬,安明伟,唐勇,等.基于数据挖掘探讨中医治疗功能性肛门直肠痛用药规律[J].中国民间疗法,2022,30(13):40-43.
[38] 吴以岭,魏聪,贾振华,等.脉络学说的核心理论——营卫承制调平[J].中医杂志,2013,54(1):3-7.

备注/Memo

备注/Memo:
基金项目:国家自然科学基金青年基金资助项目(82004362); 江苏省中医肛肠疾病临床医学创新中心项目(GCCXZX-2021)
更新日期/Last Update: 2024-10-08