基于"玄府-气液-肠络"理论探讨溃疡性结肠炎的分期诊疗思路OA

Ulcerative colitis(UC)is a chronic non-specific intestinal immune disease,characteristically involving the mucosa and submucosa of the colon and rectum.Its clinical symptoms include abdominal pain,diarrhea,tenesmus,and bloody mucus in the stool.It is characterized by prolonged duration and easy recurrence,and falls within the scope of"intestinal atrophy","diarrhea"and"chronic dysentery"in traditional Chinese medicine(TCM).This article systematically expounds the relationship among the"Xuanfu"(玄 府,microscopic channels),"Qi(气)and fluid"and"intestinal collaterals",suggesting that the three are closely related in terms of physiological functions,pathogenesis,and diagnosis and treatment.Among them,the"Xuanfu"is the microscopic channel for the circulation of Qi and fluid,and the collaterals are the pathways for the distribution of Qi and fluid.The three jointly maintain the normal circulation of Qi,blood,and fluid.If any one of these links is disrupted,it will lead to disease.Therefore,the pathogenesis of UC is proposed to be the obstruction of the"Xuanfu",the failure of Qi and fluid circulation,and the damage to the intestinal collaterals.In terms of treatment,the general principle is"opening the Xuanfu,regulating Qi and fluid,and unblocking the collaterals".In the mild activity phase,the Xuanfu is blocked,and the entry and exit of Qi are dysyegulated.In clinical classification,UC is divided into the active phase and the remission phase.Within the active phase,it is further classified into mild,moderate,and severe types according to the severity of the condition.The treatment should focus on opening the Xuanfu and restoring the opening and closing functions.In the moderate activity phase,the circulation of Qi and fluid is abnormal.The treatment should balance the promotion of Qi and fluid circulation and the opening of the Xuanfu and the relief of depression.In the severe activity phase,phlegm and blood stasis are intertwined,damaging the intestinal collaterals.The treatment should emphasize both tonifying and unblocking the collaterals and eliminating phlegm and turbidity.During the remission period,the internal organs are damaged and the residual pathogenic factors persist.In treatment,it is necessary to clear the residual pathogenic factors,replenish Qi and nourish Yin,and restore the normal functions.The appearance of extraintestinal symptoms is caused by the overflow of pathogenic toxins,which invade other organs.Therefore,when formulating prescriptions and selecting drugs,attention should be paid to the combination of wind-dispelling drugs,Qi-regulating drugs,tonifying drugs,and blood-regulating drugs.This article aims to systematically review the application progress of the"Xuanfu-Qi and fluid-intestinal collaterals"theory in the research,explain the microscopic pathological changes and overall functional disorders,and provide a more systematic and comprehensive understanding of the disease development process of and offer therapeutic approuches for UC in TCM.