成都中医药大学基础医学院,四川省成都市温江区柳台大道1166号,611137
冯全生,E-mail:fengqs118@163. com
收稿:2025-06-18,
修回:2025-11-19,
纸质出版:2026-03-17
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李林阳,刘文平,冯全生.从湿热伏邪辨治溃疡性结肠炎[J].中医杂志,2026,67(06):696-701.
LI Linyang,LIU Wenping,FENG Quansheng.Syndrome Differentiation and Treatment of Ulcerative Colitis Based on the Theory of Latent Dampness-Heat Pathogen[J].Journal of Traditional Chinese Medicine,2026,67(06):696-701.
李林阳,刘文平,冯全生.从湿热伏邪辨治溃疡性结肠炎[J].中医杂志,2026,67(06):696-701. DOI: 10.13288/j.11-2166/r.2026.06.017.
LI Linyang,LIU Wenping,FENG Quansheng.Syndrome Differentiation and Treatment of Ulcerative Colitis Based on the Theory of Latent Dampness-Heat Pathogen[J].Journal of Traditional Chinese Medicine,2026,67(06):696-701. DOI: 10.13288/j.11-2166/r.2026.06.017.
认为湿热伏邪为溃疡性结肠炎(UC)的核心病机,其致病具有伏于三阴(太阴、少阴、厥阴),发于三阳(太阳、少阳、阳明)的特点,且易从火化。病机演变可分为三期:潜伏期属太阴虚损,正虚邪恋,湿热内伏;活动期属邪透三阳,湿热外发,腐肉败血;迁延期属厥阴入络,湿热瘀结,癥瘕乃成。治疗采用分期透邪策略,即潜伏期健脾托邪、清化兼施,意在搜剔伏邪,以七味白术散或自拟楂曲健脾汤加减;活动期清解透邪、导滞通因,重在给邪出路,以枳实导滞汤为主方加减;针对迁延期厥阴入络之证,常配伍鳖甲、水蛭等虫类药化瘀通络。
It is believed that the latent dampness-heat pathogen constitutes the core pathogenesis of ulcerative colitis (UC), characterized by the pattern of "lurking in the three
yin
(
taiyin, shaoyin, jueyin
) and emerging from the three
yang
(t
aiyang, shaoyang, yangming
)", with a tendency to transform into fire. The pathogenic evolution can be delineated into three stages, the latent stage manifesting as
taiyin
deficiency with healthy
qi
deficiency and lingering pathogen, allowing dampness-heat to lurk internally; the active stage involving pathogen penetrating the three
yang
, with dampness-heat externally erupting, leading to putrefaction of flesh and impairment of blood; the prolonged stage pertaining to
jueyin
invading the collaterals, with dampness-heat and static blood binding together, culminating in the formation of abdominal masses. The therapeutic approach adopts the strategy of pathogen-expelling by stage. During the latent stage, therapy focuses on fortifying the spleen and promoting pathogens, concurrently clearing and transforming, aiming at eradicating the latent pathogens, using modified
Qiwei Baizhu Powder
(七味白术散) or self-prescribed
Zhaqu Jianpi Decoction
(楂曲健脾汤). During the active stage, emphasis is placed on clearing and resol-ving pathogens, promoting stagnation and unblocking obstruction, primarily focusing on providing an outlet for pathogens, using modified
Zhishi Daozhi Decoction
(枳实导滞汤) as the main formula. For the prolonged stage involving
jueyin
invading the collaterals, ingredients that resolve stasis and unblock c
ollaterals, such as Biejia (
Lawsonia inermis
) and Shuizhi (
Cucumis melo
), are often prescribed.
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