国医大师陈民藩教授治疗克罗恩病肛瘘的临床理论研究

A clinical and theoretical study on Professor CHEN Minfan，a national master of Chinese medicine，in the treatment of perianal fistulizing crohn’s disease

关键词:  克罗恩病肛瘘  存体寡损  形神兼顾  挂线疗法  肛门功能保护  陈民藩

Key words:  perianal fistulizing Crohn’s disease  body?preserving and damage?minimizing  holistic approach  thread? dragging therapy  anal function preservation  CHEN Minfan

摘要:

克罗恩病肛瘘具有反复发作、迁延不愈的特点，临床治疗需兼顾肛瘘根治与肛门功能保护之间的平衡。国医大师陈民藩教授提出以“存体寡损-形神兼顾”为核心的治疗原则，通过术前测压、术中“皮桥护形”与“挂线寡损”等微创术式最大限度保护肛门形态结构与功能，并结合术后分期中药内服与外治促进形神协同康复；治疗体系融合现代诊断技术与中医辨证思维，体现“急则治标，缓则治本”“祛邪不伤正”的学术思想，为该疾病的个体化、多维度诊疗提供了理论依据与实践路径。

Abstract:

Perianal fistulizing Crohn’s disease(pfCD) is characterized by its recurrent and refractory nature， necessitating a clinical approach that balances radical fistula management with the preservation of anal function. Professor CHEN Minfan，a national master of traditional Chinese medicine，proposed a core treatment principle of “Minimally Damaging and Structure-Preserving”combined with“Harmonizing the Body and Spirit”. This approach emphasizes protecting the anatomical structure and function of the anus through preoperative manometric assessment，intraoperative minimally invasive techniques such as“skin- bridge protection”and“thread-dragging with minimal tissue damage”，as well as staged postoperative herbal medicine administration and external treatments to promote holistic recovery. This treatment system integrates modern diagnostic technologies with traditional Chinese medicine(TCM) syndrome differentiation，reflecting the TCM academic tenets of“treating the branch during acute stages and the root during remission”and“eliminating pathogens without compromising healthy qi”. It provides a theoretical foundation and practical pathway for individualized and multidimensional treatment of pfCD.