基于"阳虚三夺统于脾"理论探讨Ⅲ期混合痔病机演变与辨治OA

Based on the theory of"yang deficiency causing three depletions in the spleen",this paper explores the pathogenesis evolution and treatment strategies of stage Ⅲ mixed hemorrhoids.Professor Sun Huazhong identifies yang deficiency as the fundamental pathogenic factor of the disease,summarizing its evolution into three distinct stages:initially,yang deficiency leads to spleen dysfunction and qi deficiency with sinking qi("qi depletion");subsequently,kidney yang gets depleted,causing instability in essence retention("essence depletion");ultimately,vital gate fire diminishes,leading to internal generation of cold-dampness accompanied by deficiency-heat disturbance("fire depletion").Accordingly,its treatment should be stage-specific,with replenishing spleen yang as the core principle.Clinically,during the"qi depletion"stage,modified Buzhong Yiqi Decoction is commonly prescribed to tonify qi,invigorate the spleen,and ascend yang qi and relieve qi desertion;in the"essence depletion"stage,Xuefu Zhuyu Decoction combined with essence-replenishing herbs is utilized to warm the kidneys,nourish essence,and promote blood circulation for removing blood stasis;finally,in the"fire depletion"stage,modified Huaihua Powder is adopted to warm yang,promote diuresis,and clear deficiency-heat.This phased treatment approach aims to alleviate the symptoms of the disease,enhance patients'quality of life,and provide novel insights for the clinical management of stage Ⅲ mixed hemorrhoids.