| 引用本文: |
汪洋, 宋兴磊, 刘应科.基于“顺通理论”的小儿泄泻病机新探与辨治思路[J].湖南中医药大学学报,2026,46(4):813-818[点击复制] |
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| 基于“顺通理论”的小儿泄泻病机新探与辨治思路 |
| 汪洋,宋兴磊,刘应科 |
| (北京中医药大学东直门医院, 北京 100700;北京按摩医院, 北京 100020) |
| 摘要: |
| 小儿泄泻为儿科常见病，具有病程迁延、反复发作的特点，严重影响儿童生长发育。本文创新性提出“顺通理论”，系统阐释小儿泄泻的病机与辨治体系。该理论以“顺天时、顺时势、顺本能”为原则解析病机，揭示本病关键在于“顺失则逆，通滞则泻”，即因三焦枢机失运，导致天人失和、邪正交争及脏腑气化失调的动态失衡。在此基础上，构建“通天地、通邪气、通脏腑”的“三通”治法。该治法通过三因制宜以调和天人、因势利导以祛除邪滞、顺应脏腑特性以恢复功能，最终实现气机升降平衡。文中详细阐述“三通”治法的临床应用要点，并附典型医案加以印证，突破传统“脾虚湿蕴”的单一病机认识，从三焦气化动态失衡的角度重新阐释本病的病机框架，为提升临床疗效、减少复发提供新的诊治思路。 |
| 关键词: 小儿泄泻|顺通理论|三焦枢机|气机升降|三因制宜|病机框架|辨治思路 |
| DOI：10.3969/j.issn.1674-070X.2026.04.023 |
| 投稿时间：2025-07-12 |
| 基金项目:首都卫生发展科研专项(首发2022-2-7011);中华中医药学会青年求实项目(2021-QNQS-02);中华中医药学会临床优势病种青年学术沙龙项目(2024-QNXSSL-01);北京市中医药管理局北京中医药薪火传承“新3+3”工程首批示范案例项目(2023-ZYSF-24) |
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| Novel insights into the pathogenesis and clinical approach to differentiating and treating infantile diarrhea based on the "following and unblocking theory" |
| WANG Yang, SONG Xinglei, LIU Yingke |
| (Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China;Beijing Massage Hospital, Beijing 100020, China) |
| Abstract: |
| Infantile diarrhea is a common pediatric condition characterized by a protracted course and recurrent episodes,which can seriously affect the growth and development of children. This paper innovatively proposes the "following and unblocking theory" to systematically elucidate the pathogenesis and the system of pattern identification and treatment for infantile diarrhea. The theory analyzes the pathogenesis based on the principles of "following the rhythms of nature, following the current circumstances,and following the innate instincts", revealing that the key to this disease lies in the notion that "failure in following leads to disharmony, while blockage leads to diarrhea." That is, due to the dysfunction of the pivot mechanism of sanjiao, a dynamic imbalance arises, characterized by disharmony between man and nature, struggle between healthy qi and pathogenic factors, and dysregulation of qi transformation in the zang-fu organs. On this basis, the "three unblocking" therapeutic principles— "unblocking heaven and earth, unblocking pathogenic qi, and unblocking the zang-fu organs" —are established. These principles aim to harmonize the relationship between man and nature by adapting treatment to the individual, season, and local conditions; eliminate pathogenic stagnation by guiding it according to its natural tendency; and restore the functions of the zang-fu organs by complying with their inherent characteristics, ultimately achieving a balanced ascending and descending movement of qi. This paper elaborates on the key clinical applications of the "three unblocking" principles and provides representative medical records for validation.Breaking through the traditional understanding of a single pathogenesis of "spleen deficiency with dampness retention," this theory reinterprets the pathogenetic framework of this disease from the perspective of dynamic imbalance in sanjiao qi transformation,offering a new diagnostic and therapeutic approach to improve clinical efficacy and reduce recurrence. |
| Key words: infantile diarrhea|following and unblocking theory|pivot mechanism of sanjiao|qi ascending and descending|treatment adaptation to the individual,season,and local conditions|framework of pathogenesis|clinical approach to differentiating and treating |
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