基于“焦膜伏风”理论辨治腹泻型肠易激综合征

Syndrome Differentiation-Based Treatment of Diarrhea-Predominant Irritable Bowel Syndrome Based on the Theory of "Latent Wind in the Triple Energizer Membrane"

摘要:

腹泻型肠易激综合征（IBS-D） 是一种常见的功能性肠病，以腹痛、腹泻及排便习惯改变为主要表现，其病因复杂、发病率高，且发病机制尚未完全明确。“焦膜伏风”理论认为其核心病机为风邪伏藏于三焦焦膜，遇新邪引动则下扰肠腑，致肠道气机紊乱，发为IBS-D。IBS-D“发作突止、部位游走、反复难愈”的临床特点与伏风“善行数变、其性主动、伏而后发”的致病特性高度契合。据此，治疗上当分期论治，发作期侧重疏风透邪为法，缓解期注重调理焦膜及脏腑、息风搜风。

Abstract:

Abstract： Diarrhea-predominant irritable bowel syndrome （IBS-D） is a common functional bowel disorder characterized by abdominal pain，diarrhea，and altered bowel habits. It has a complex etiology，high incidence，and with no identifiable pathogenesis. The theory of "latent wind in the triple energizer membrane" proposes that the core pathogenesis of IBS-D is the latency of pathogenic wind in the triple energizer membrane. When triggered by a new pathogenic factor， this latent wind disturbs the intestines， leading to disorder of intestinal qi movement and the development of IBS-D. The clinical features of IBS-D—sudden onset，wandering of the affected sites，and recurrent and refractory nature—closely align with the pathogenic characteristics of latent wind，which is known for "being good at rapid migration and frequent change， governing stirring up， and lurking before onset." Accordingly， treatment should be stage-specific： during the acute phase， the focus is on dispersing wind and dispelling pathogenic factors； during the remission phase，emphasis is placed on regulating the triple energizer membrane and the zang-fu organs，as well as extinguishing and expelling wind.