邝卫红基于脾胃为气机升降枢纽治疗泄泻经验介绍
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R249;R256.34

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邝卫红广东省名中医工作室建设项目(粤人社函〔2022〕193号)


Introduction of KUANG Weihong’s Experience in Treating Diarrhea Based on Spleen- Stomach as the Pivot of Qi Ascending-Descending Movement
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    摘要:

    介绍邝卫红教授治疗泄泻的临床经验。邝卫红教授认为,泄泻的关键病机为脾虚湿蕴,而脾胃为 气机升降之枢纽,指出调脾胃升降之枢是治疗泄泻病之关键。临证诸法有:①调脾胃气机升降,重在升健脾 气:常以四君子汤为基本方,以黄芪或五指毛桃配枳壳药对以升降脾胃之枢;②升发疏达肝胆之气,调少阳之 枢助升降:常以柴胡配防风调二枢,即脾胃升降之枢及少阳气机之枢;③温肾暖土助升降:常以附子理中汤为 基本方,以附子配干姜药对温暖脾肾,还结合岭南地域特点,选用附子配牡蛎药对,以牡蛎潜降附子之燥热升 散;④调脾胃之枢不利之变证,包括平寒热之变,行气血之郁:常用药对干姜配黄连等以辛开苦降、平调寒 热;临证尚随症用药,以调和气血之郁。此外,邝卫红教授还强调,患者当配合运动、饮食等生活调摄方式, 方能起到良好治疗效果。

    Abstract:

    Abstract:To introduce Professor KUANG Weihong's experience in treating diarrhea. Professor KUANG holds that the key pathogenesis of diarrhea is spleen deficiency with dampness accumulation. He emphasizes that the spleenstomach serves as the pivot of qi ascending-descending movement,and regulating this pivotal mechanism is crucial in treating diarrhea. Clinical methods include: ①Regulating the ascending-descending movement of spleen-stomach qi should focus on lifting spleen qi:Si Junzi Decoction is often used as the foundational prescription. The herbal pair of Astragali Radix or Ficus Simplicissima Lour with Aurantii Fructus is employed to balance the pivot of spleen-stomach qi dynamics; ② Promoting the free flow of liver-gallbladder qi to assist the pivot of Shaoyang qi movement: The combination of Bupleuri Radix with Saposhnikoviae Radix is used to regulate two pivots—the ascending-descending pivot of spleen-stomach and the Shaoyang pivot; ③ Warming kidney and spleen to aid qi ascending-descending movement:Fuzi Lizhong Decoction is commonly used as the foundational prescription,with Aconiti Lateralis Preparata paired Zingiberis Rhizoma to warm the spleen and kidney. Additionally, based on Lingnan regional characteristics, Radix Aconiti Lateralis Preparata is often combined with Ostreae Concha to subdue Radix Aconiti Lateralis Preparata's dryness-heat and ascending-dispersing properties;④Regulating stagnation of the spleen-stomach pivotal mechanism: This includes balancing cold-heat and resolving qi-blood stagnation. Common herbal pair consists of Zingiberis Rhizoma and Coptidis Rhizoma for pungent-opening and bitter-descending, balancing cold and heat. In clinical practice, prescriptions are adjusted flexibly according to the specific symptoms to regulate the stagnation of qi and blood. Professor KUANG also emphasizes that patients should combine lifestyle adjustments such as exercise and dietary regulation to achieve optimal therapeutic effects.

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郭称香,指导:邝卫红.邝卫红基于脾胃为气机升降枢纽治疗泄泻经验介绍[J].新中医,2026,58(2):158-162

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  • 在线发布日期: 2026-01-29
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