基于"厚肠理论"探讨腹泻型肠易激综合征病机特点及辨治策略OA

Diarrhea-predominant irritable bowel syndrome(IBS-D)is a highly prevalent functional bowel disorder characterized by persistent symptoms,and recurrent course,which seriously affects the quality of life of patients."Intestine-nourishing"refers to"benefiting the intestines",meaning restoring the thickness of the"fatty layer"of the intestinal wall.and its astringent function.Based on the"intestine-strengthening theory",this article explores the pathogenic characteristics of IBS-D.It posits that although the disease is located in the intestines,its core pathogenesis is closely related to the imbalance of the spleen,liver,and kidneys,that is,"visceral disorders leading to intestinal thinning".The onset of the disease begins with the spleen's failure of transportation and transformation,with the intestines being thin and lacking nourishment;The gradual development of the disease is marked by liver depression invading the spleen leading to intestinal thinning and loss of consolidation;The severity of the disease is characterized by the decline of kidney yang,with the intestines lacking sufficient warming and nourishment;The final stage of the disease is characterized by cold-heat complex disorder,and intestinal thinning with impaired restraint,which results in a weakened intestinal mucosal barrier and a decline in the intestine's transportation-consolidation functions.The treatment should focus on identifying the location of the disease,distinguishing cold-heat and deficiency-excess patterns,and adopting a stratified treatment strategy of"strengthening the middle jiao,regulating the liver and spleen,warming the life gate,and harmonizing cold-heat"to restore the thickness and astringent function of the"fatty layer"of the intestinal wall,achieving the goal of"thinning gradually thickens,and loose gradually solidifies",providing new ideas for the clinical prevention and treatment of IBS-D.