从痰热论治刍议加味黄连温胆汤之异病同治OA

By analyzing the causes of phlegm-heat formation,this study identified phlegm-heat as the key pathomechanism.Based on the theoretical basis of treating diseases from the aspect of phlegm-heat integrating the formulation principle of the modified Huanglian Wendan decoction(加味黄连温胆汤),this paper explored the practice of treating different diseases by the same therapy reflected by this decoction in clinical application.The Modified Huanglian Wendan decoction is formulated by adding Huanglian(Rhizoma Coptidis)to the Wendan decoction.The formula as a whole utilizes Huanglian to clear heat,dry dampness,purge heart fire,and relieve restlessness.Banxia(Rhizoma Pinelliae),Chenpi(Pericarpium Citri Reticulatae),Fuling(Poria Cocos),and Gancao(Radix et Rhizoma Glycyrrhizae)work together to fortify the spleen,dry dampness,and resolve phlegm.Zhishi(Fructus Aurantii Immaturus)promotes Qi(气)flow and dispels phlegm,while Zhuru(Caulis Bambusae in Taenia)clears heat and resolves phlegm.The combination of these herbs achieves the effects of clearing heat,resolving phlegm,regulating Qi flow,and harmonizing the middle Jiao(焦).This formula is a representative prescription in traditional Chinese medicine(TCM)for treating internal accumulation of phlegm-heat.Its application embodies the core concept of"treating different diseases by the same therapy"in TCM,meaning that the same therapeutic principle and formula can be applied to different diseases as long as the underlying pathomechanism is the same.In modern clinical practice,TCM practitioners adhere to the key pathomechanism of"phlegm-heat"and continuously expand the clinical application spectrum of the modified Huanglian Wendan decoction.In cardiovascular diseases,such as hypertension and coronary heart disease,the pathomechanism often involves phlegm-heat intermingling,which disturbs the heart-mind and obstructs the blood vessels.This formula can regulate blood pressure and improve myocardial blood supply by clearing heat,resolving phlegm and activating chest Yang.Regarding metabolic diseases,such as type 2 diabetes and metabolic syndrome,their development is closely related to internal phlegm-heat accumulation,which obstructs the middle Jiao,affecting the ascent,descent,and transformative functions of Qi movement.This formula can assist in ameliorating glucose and lipid metabolism disorders by clearing heat,heat resolving phlegm and regulating spleen-stomach function.Furthermore,in neuropsychiatric and pediatric diseases,such as anxiety,insomnia,and pediatric tic disorders,TCM attributes their pathomechanism to phlegm-heat disturbing the heart or liver-wind combined with phlegm-heat.This formula clears heat,resolves phlegm,calms the heart,and tranquilizes the mind,while also pacifying the liver and extinguishing wind,thereby achieving good therapeutic effects.These expanded applications are all based on the common pathological foundation of"phlegm-heat",reflecting the characteristic of"treating different diseases by the same therapy"in TCM's pattern differentiation and treatment.Against the backdrop of changes in the modern disease spectrum,treatment based on the phlegm-heat theory provides important therapeutic strategies for various chronic diseases,metabolic disorders,and psychosomatic illnesses.It also highlights the vitality and adaptability of classical formulas in contemporary clinical practice.Future efforts should focus on further clinical observation and mechanism research to deepen the understanding of the connotation of this formula's principle of"treating different diseases by the same therapy".