白长川教授承袭方证辨证体系、仲景学说及历代名家之大成,并在金元四大家李杲“内伤脾胃”学术思想的基础上,融会贯通,着眼于当下自然环境、社会因素、人类生活方式及饮食结构的变化,病种和证候也相应发生变化,在临床诊疗感悟思考中,创立了“滞伤脾胃,百病由生”的理论。白长川教授在临床治疗心衰患者时发现,“滞伤脾胃”理论与心衰的发病和发展有着密切的联系,从脾胃论治心衰取得了很好的疗效。本文旨在探讨白长川教授运用“滞伤脾胃,百病由生”的学术思想在慢性心力衰竭的治疗经验,为心力衰竭后续的规范化治疗提供理论依据。
Professor Bai Changchuan inherited the system of syndrome differentiation based on prescriptions and syndromes, the doctrines of Zhongjing, and the achievements of famous scholars throughout history. On the basis of Li Gao's academic thought of "internal injury to the spleen and stomach" among the Four Great Masters of the Jin and Yuan Dynasties, he integrated and mastered it.Focusing on the current changes in the natural environment, social factors, human lifestyles and dietary structures, the types and syndrome types of diseases also change accordingly.In the process of clinical diagnosis and treatment experience and reflection, a systematic theory of "Indigestion of Spleen and Stomach, Caucusing Various Diseases" has been formed in clinical practice.Professor Bai Changchuan discovered during his clinical treatment of heart failure patients that the theory of "Indigestion of Spleen and Stomach" is closely related to the onset and development of heart failure. He achieved excellent therapeutic effects in treating heart failure based on the spleen and stomach theory.This article aims to explore Professor Bai Changchuan's experience in treating chronic heart failure by applying the academic thought that "Indigestion of Spleen and Stomach, Caucusing Various Diseases", providing a theoretical basis for the subsequent standardized treatment of heart failure.
[1] 施琳琳, 陈芳, 吴之茵, 等.理气通便合剂调节脑肠肽改善便秘型肠易激综合征大鼠内脏高敏感的实验研究[J].浙江中医杂志, 2021, 56(8):550-552.
[2] 李岩, 姚鑫洁.饮食因素对功能性消化不良的影响[J].中国中西医结合消化杂志, 2023, 31(10):747-750.
[3] Holland A, Bon-Frauches A, Keszthelyi D, et al.The enteric nervous system in gastrointestinal disease etiology[J].Cell Mol Life Sci, 2021, 78(10):4713-4733.
[4] Moncrieff J, Cooper RE, Stockmann T, et al.The serotonin theory of depression:a systematic umbrella review of the evidence[J].Mol Psychiatry, 2023, 28(8):3243-3256.
[5] Sun X, Li N, Zhong P, et al.Development of MAO-A and 5-HT2AR dual inhibitors with improved antidepressant activity[J].J Med Chem, 2022, 65(19):13385-13400.
[6] Zhang J, Chen T, Wen Y, et al.Insights and future prospects of traditional Chinese medicine in the treatment of functional dyspepsia[J].Phytomedicine, 2024, 127:155481.
[7] 徐玉龙, 管建国, 宗桂荣, 等.急性胰腺炎患者血清二胺氧化酶及D-乳酸水平与肠道功能的关系[J].重庆医学, 2021, 50(15):2583-2585, 2591.
[8] 漆利红, 李生财, 赵世伟.李生财治疗寒邪客胃型胃脘痛的临床经验总结[J].中医临床研究, 2024, 16(21):36-40.
[9] 周衡, 林华胜, 刘熙荣, 等.半夏泻心汤合三联疗法对Hp相关性慢性胃炎患者的疗效及血清CagA、VacA的影响[J].湖南中医杂志, 2020, 36(11):8-11.
[10] 宁曹, 庞浇安, 叶桂源, 等.基于络病理论加味香砂六君子汤联合四联法治疗脾虚湿盛证慢性萎缩性胃炎临床疗效观察[J].亚太传统医药, 2024, 20(5):80-86.
[11] 陈朴, 赵静, 吴琼, 等.不同营养支持方式对脓毒症患儿肠道屏障功能及肠源性感染指标的影响[J].中华医院感染学杂志, 2023, 33(1):142-146.
[12] 王辉, 蒋庆雨.宣肺通腑法防治老年脓毒症急性胃肠损伤的临床研究[J].中国防痨杂志, 2024, 46(S01):109-112.
[13] 甘思玲, 高飞.Cajal间质细胞在糖尿病胃轻瘫中的研究进展[J].现代消化及介入诊疗, 2021, 26(1):127-132.
[14] 岳太绘.运用《金匮要略》“病痰饮者, 当以温药和之”治疗疑难心衰病320例[J].中国医药科学, 2020, 10(21):76-80, 87.
[15] Pasinie, Aquilanir, Testac, et al.Pathogenic gut florain patients with chronic heart failure[J].JACC:HeartFailure, 2016, 4(3):220-227.
[16] 张介宾.类经:中医书三十二卷[M].北京:中医古籍出版社, 2016:29.
[17] 陈刚, 苏韫, 刘永琦, 等.从“脾胃-肠”轴与肠道菌群相关性出发对中医药临床辅助肿瘤化疗的探讨[J].时珍国医国药, 2019, 30(3):644-646.
[18] 朱禹, 岳仁宋, 税嘉诚, 等.从肠道菌群探讨“挽精逐浊-气化”改善胰岛素抵抗[J].四川中医, 2019, 37(8):18-20.
[19] 李夏.中西医结合治疗肠易激综合征的进展[C].中国中西医结合学会消化系统疾病专业委员会.第三十届全国中西医结合消化系统疾病学术会议论文集.郑州:中国中西医结合学会, 2018:1.
[20] 张建平, 张淼, 王焕玲, 等.田芬兰对心脾相关的认识[J].河南中医, 2015, 35(1):33-34.
[21] 孟凡珍, 陈慧肃.解建国教授治疗心衰经验[J].四川中医, 2010, 28(6):3-4.
[22] 许瑞.从脾胃论治慢性心力衰竭[D].合肥:安徽中医药大学, 2015.
[23] 金晓, 徐丹苹, 吴焕林.吴焕林教授从脾胃论治慢性心力衰竭经验[J].中国中西医结合杂志, 2019, 39(4):497-499.
[24] 林家茂, 李珩, 郭伟星, 等.周杰教授从“心脾相关”论治慢性心力衰竭探析[J].世界中西医结合杂志, 2014, 9(4):344-346, 350.
