基于浊毒理论和气机升降学说探讨腹泻型肠易激综合征的分型论治OA

Based on the turbid-toxin theory and the qi-movement ascent-descent doctrine,the core pathogenesis of irritable bowel syn-drome with diarrhea(IBS-D)is"accumulation of turbid toxins and disordered qi movement."Dysfunction of qi ascent-descent serves not only as the cause of turbid-toxin generation but also as the consequence induced by turbid toxin.The two interact as both cause and effect and form a vicious cycle.Turbid toxins constitute the pathological basis for the onset of IBS-D and the key factor for recurrent dis-ease episodes.Dysfunction of qi ascent-descent acts as the initiating factor and functional pivot of disease progression.Therefore,treatment should primarily focus on"resolving turbidity and detoxifying,"supplemented by"regulating and restoring the ascending and descending functions"to restore the pivotal balance between ascending clear qi and descending turbid substances,thereby reinstating normal intestinal transmission.According to differences in pathogenic factors complicated with turbid toxins as well as visceral deficiency-excess conditions,IBS-D is mainly treated under three syndrome types.For the syndrome of turbid toxins complicated with downpour of dampness-heat,the treatment principle is clearing heat,draining dampness,resolving turbidity and detoxifying,with the self-formulated Intestine-Cleaning and Diarrhea-Stopping Formula applied.For the syndrome of turbid toxins complicated with spleen-stomach deficiency,the therapeutic strate-gies are invigorating the spleen,tonifying qi,eliminating dampness and dispelling turbidity,using the self-formulated Spleen-Strengthening and Intestine-Securing Formula.For the syndrome of turbid toxins complicated with liver depression and spleen deficiency,the treatment aims to soothe the liver and invigorate the spleen to smooth qi movement,detoxify and resolve turbidity to eliminate stagnation,and harmo-nize intestinal fu-organ functions,with the self-formulated Stomach-Harmonizing and Diarrhea-Stopping Formula adopted.