国医大师丁樱教授从“脏腑别通”理论辨治小儿遗尿症

Differentiation and treatment of pediatric enuresis under the guidance of Zang-Fu organ extraordinary connection theory

关键词:  脏腑别通  功能失衡  升降失常  小儿遗尿症

Key words:  zang-fu organ extraordinary connection theory  homeostatic imbalance  dysregulation of ascending and descending  pediatric enuresis

摘要:

国医大师丁樱教授突破小儿遗尿症从肾-膀胱治疗的传统框架，从心与胆、肺与膀胱、脾与小肠、肾与三焦角度阐释了小儿遗尿症与“脏腑别通”理论的相通性，认为心胆失主、脏腑神乱、肺气失调、膀胱失约、脾运不健、小肠主液失常、肾阳亏虚、三焦失和均可导致小儿遗尿症，重视整体观念与辨证论治两者结合，进而提出养心神，利胆气；补肺气，温膀胱；健脾气，调小肠；补肾气，疏三焦更为精准的治疗方法。临床疗效显著，极大地拓宽了小儿遗尿症的中医临证思路，本文将临证思路和经验总结如下。

Abstract:

[Objective] To explore the clinical experience of National Traditional Chinese Medicine（TCM）Master Professor DING Ying in treating pediatric enuresis based on the zang-fu Organ Extraordinary Connection Theory. [Methods] This article applies this theory to explain the correlation between pediatric enuresis and the theory from the perspectives of the heart and gallbladder，lung and bladder，spleen and small intestine，and kidney and sanjiao （triple energizer）. [Results] It proposes that dysfunction in any of these interconnected pairs—such as heart-gallbladder imbalance leading to mental disturbance，lung qi dysfunction causing loss of bladder restraint，impaired spleen transport affecting small intestine fluid regulation，or kidney yang deficiency resulting in sanjiao disharmony- can lead to pediatric enuresis. Consequently，more precise treatment methods are suggested：nourishing heart spirit and regulating gallbladder qi；supplementing lung qi and warming the bladder；strengthening spleen qi and regulating the small intestine；and tonifying kidney qi and unblocking the sanjiao. [Conclusion] These methods have demonstrated significant clinical efficacy，greatly enriching the clinical reasoning of TCM for pediatric enuresis. This article summarizes the clinical insights and experience as follows.