| 吴佳,夏永良,陈意.基于“土得木而达”理论探析夏永良运用逍遥散合痛泻要方治疗IBS-D的证治经验[J].浙江中西医结合杂志,2026,36(5): |
| 基于“土得木而达”理论探析夏永良运用逍遥散合痛泻要方治疗IBS-D的证治经验 |
| Xia Yongliang’s Application of Xiaoyao San and Tongxie Yaofang for IBS-D: Insights from the “Tu De Mu Er Da” Theory |
| 投稿时间：2025-12-17 修订日期：2026-01-19 |
| DOI： |
| 中文关键词: 腹泻型肠易激综合征 土得木而达 肝郁脾虚 逍遥散 痛泻要方 |
| 英文关键词:Diarrhea-predominant Irritable Bowel Syndrome (IBS-D) Tu De Mu Er Da (the spleen becomes functional through the activity of the liver) Liver Depression and Spleen Deficiency Xiaoyao San Tongxie Yaofang |
| 基金项目:陈意全国名中医传承工作室建设项目(No.国中医药办人教函[2022]245号)；陈意全国名老中医药专家传承工作室建设项目(No.国中医药人教发[2011]41号)；浙江省陈意国医名师传承工作室建设项目(No.浙中医药[2020]12号) |
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| 中文摘要: |
| 本文探讨了夏永良基于“土得木而达”理论治疗腹泻型肠易激综合征（IBS-D）的思想和经验。腹泻型肠易激综合征是一种常见的功能性肠病，西医对症治疗存在局限性，而中医药在整体调节方面展现出优势。通过系统梳理“土得木而达”的理论渊源，阐述了肝之（木）疏泄与脾之（土）运化之间“木疏土运”的生理关系，及木郁乘土或土虚木贼导致腹痛、腹泻的病理机制。针对IBS-D肝脾失调的核心病机，夏师主张以调和肝脾为治则，临床擅用逍遥散合痛泻要方，共奏疏肝健脾、祛湿止泻之效。并结合现代药理学、临床研究及典型病例分析展示了该理论的临床应用效果。研究表明，此法疗效显著，值得进一步研究和推广。 |
| 英文摘要: |
| This article examines Dr. Xia Yongliang’s clinical approach to treating diarrhea-predominant irritable bowel syndrome (IBS-D) based on the theory of Tu De Mu Er Da, which posits that the Spleen (Earth) attains functional patency through the activity of the Liver (Wood). IBS-D, a common functional bowel disorder, presents limitations under conventional Western symptomatic management, whereas Traditional Chinese Medicine (TCM) demonstrates holistic regulatory strengths. A systematic review of Tu De Mu Er Da clarifies the Liver-Spleen relationship: the Spleen’s transportation and transformation rely on the Liver’s free-flowing (shu-xie) function. Pathological mechanisms include Liver-qi stagnation invading the Spleen-Stomach, or Spleen-Stomach deficiency being constrained by hyperactive Liver-qi, both manifesting as abdominal pain and diarrhea. Targeting the Liver-Spleen disharmony central to IBS-D, Dr. Xia emphasizes harmonizing these organs. Clinically, he applies a modified combination of Xiaoyao San and Tongxie Yaofang to soothe Liver-qi, strengthen the Spleen-Stomach, resolve dampness, and stop diarrhea. Supported by pharmacological research, clinical studies, and case analyses, this article illustrates the practical efficacy of this approach. Clinical outcomes confirm its therapeutic value, demonstrating the precision of Tu De Mu Er Da-guided treatment and offering a systematic paradigm for IBS-D management worthy of further study and dissemination. |
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