从湿热伏邪辨治溃疡性结肠炎OA

It is believed that the latent dampness-heat pathogen constitutes the core pathogenesis of ulcerative colitis(UC),characterized by the pattern of"lurking in the three yin(taiyin,shaoyin,jueyin)and emerging from the three yang(taiyang,shaoyang,yangming)",with a tendency to transform into fire.The pathogenic evolution can be delineated into three stages,the latent stage manifesting as taiyin deficiency with healthy qi deficiency and lingering pathogen,allowing dampness-heat to lurk internally;the active stage involving pathogen penetrating the three yang,with dampness-heat externally erupting,leading to putrefaction of flesh and impairment of blood;the prolonged stage pertaining to jueyin invading the collaterals,with dampness-heat and static blood binding together,culminating in the formation of abdominal masses.The therapeutic approach adopts the strategy of pathogen-expelling by stage.During the latent stage,therapy focuses on fortifying the spleen and promoting pathogens,concurrently clearing and transforming,aiming at eradicating the latent pathogens,using modified Qiwei Baizhu Powder(七味白术散)or self-prescribed Zhaqu Jianpi Decoction(楂曲健脾汤).During the active stage,emphasis is placed on clearing and resol-ving pathogens,promoting stagnation and unblocking obstruction,primarily focusing on providing an outlet for patho-gens,using modified Zhishi Daozhi Decoction(枳实导滞汤)as the main formula.For the prolonged stage involving jueyin invading the collaterals,ingredients that resolve stasis and unblock collaterals,such as Biejia(Lawsonia inermis)and Shuizhi(Cucumis melo),are often prescribed.