文献类型：期刊文献

中文题名：李应存敦煌“大补脾汤”辨治消化性溃疡(胃脘痛)

英文题名：LI Yingcun’s Dunhuang "Dabupi Decoction" for the Differentiation and Treatment of Peptic Ulcer(Stomach Wantong)

作者：梁永瑞[1];李应存[1];李鑫浩[2];杨佳楠[1];刘玲[1]

第一作者：梁永瑞

机构：[1]甘肃中医药大学敦煌医学与转化教育部重点实验室,甘肃兰州730020;[2]北京中医药大学中医学院,北京100029

第一机构：甘肃中医药大学科研实验中心（甘肃省中医药标准化技术委员会秘书处）

年份：2019

卷号：33

期号：10

起止页码：14

中文期刊名：实用中医内科杂志

外文期刊名：Journal of Practical Traditional Chinese Internal Medicine

基金：敦煌医学文献研究及数字化信息提取与整理项目(DHYX1415-001);敦煌医学诊疗技术与临床应用建设项目(DHYX1415-004)

语种：中文

中文关键词：消化性溃疡;胃脘痛;大补脾汤;补中健脾;理气和胃;敦煌医学;李应存;老中医经验

外文关键词：peptic ulcer;epigastralgia;enriching spleen decoction;strength the middle Qi and spleen;smooth Qi regulation and harmonize stomach;Dunhuang medicine;LI Yingcun;prestigious TCM doctors’experiences;TCM prescription

摘要：消化性溃疡主要为中虚气滞,可归属"胃脘痛"范畴,其病机是由情志所伤,肝气郁结,横逆犯胃,或饮食所伤,损及脾胃,脾不运化,胃失和降,气机阻滞,不通则痛。李应存教授应用敦煌大补脾汤为主方温中补虚,健脾和胃,根据其独特的病因病机,辅以缓急止痛,调畅气机之品;在遣方用药中体现缓则治其本,急则治其标的组方特点。内伤邪气(不论寒湿、痰热)或原发脏腑疾病相互作用,影响肺脏肃降功能,气不得降而上逆,发为咳嗽;提出"咳之要在于宣降,治痰必先理气"的独到见解,重在肃降,佐以宣发,根据肺失宣降程度,酌配升降药对及调理气机之品;在组方遣药配伍中体现宣与降的侧重,注意宣降药味、剂量比例;脾胃乃气机升降枢纽,痰瘀互结是肺病重要病机,尚须配以活血化瘀之药。
Peptic Ulcer(PU)refers to middle Qi deficiency and stagnation,which belongs to‘epigastralgia’.The pathogenesis of PU is due to emotional injury,liver depression and Qi stagnation,liver Qi go against the stomach,or due to the dietary injury,damage to the gastrointestine,the spleen works insufficiently,then the stomach Qi descending function is obstructed,leading to the hindrance of functional activities of Qi,and resulting in the general pain.Professor LI Yingcun applies the Dunhuang enriching spleen decoction as main prescription to warm the gastrointestine and restore deficiency,strength the spleen and harmonize the stomach,according to its unique etiology and pathogenesis,supplemented with the medicine of relieving pain and relaxing Qi;the process of writing prescription and dispensing reflects the characteristics of prescription that cure for symptons when it is urgent,cure for origins when it is mild.Because of internal body affected by the pathogenic factors(whether cold dampness or phlegmatic heat),or the interaction of primary visceral diseases,influencing the lung functions of purification and descending,then Qi can not descend but go up adversely,leading to cough;meanwhile,professor LI puts forward the original opinions that‘cure for cough relies on descending,cure for phlegm relies on relieving Qi’,which concentrates on the lung function of Qi descending,supplemented with functions of Qi rising.According to the degree of pulmonary dysfunction of Qi descending and rising,giving the medicine prescription of adjusting operational mechanism of Qi reasonably;the process of composing medicine reflects the particular emphasis of Qi rising and descending,focuses on the proportion of amount and dosage of herbal medicine for Qi rising and descending;I addition,spleen and stomach are the hub of the operational mechanism of Qi rising and desceng,the combination of phlegm turbidity and blood blocks is the critical cause of lung disease,the medicine for activating blood circulation and removing blood stasis should still be added.