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师从国医大师徐景藩,用“仙鹤草”治疗“脾胃病”四法-
师从国医大师徐景藩,用“仙鹤草”治疗“脾胃病”四法

师从国医大师徐景藩,用“仙鹤草”治疗“脾胃病”四法

周晓波师从国医大师徐景藩教授,继承了孟河医派特色,治疗脾胃病以平补中焦为原则,药用轻灵、平和,且擅运用仙鹤草,临床每获良效。

师从国医大师徐景藩,用“仙鹤草”治疗“脾胃病”四法

国医大师徐景藩

仙鹤草始见于《图经本草》,又名狼牙草、龙牙草、牙子、石打穿,脱力草,性微寒,味苦、涩;归心、肝经,具收敛止血、止痢、补虚壮体、截疟、解毒杀虫等多种功效。现将周晓波在辨证论治基础上运用仙鹤草治疗幽门螺杆菌感染相关性胃炎、消化性溃疡及胃癌癌前病变、溃疡性结肠炎、胃食管反流病经验介绍如下。

1、抗菌杀虫能清幽

幽门螺杆菌最早由胃黏膜中分离,其空泡毒素可损伤胃黏膜,促进炎症、溃疡形成,甚至干扰基因重组过程,增强癌组织的阳性信号表达,促进胃癌的发生、发展。幽门螺杆菌属中医“虫毒”、“热毒”之邪。其致病可表现为上腹部隐痛、饱胀,纳差,嗳气等,属中医“痞满”、“胃痛”范畴。

周师认为幽门螺杆菌感染相关性胃炎,病机多以脾虚为本,湿热为标,常兼有气滞。脾虚可见脾气虚,脾阴虚。治疗上,脾气虚常用党参、白术、茯苓、山药、薏苡仁以益气健脾化湿;脾阴虚以沙参、麦冬、石斛益胃养阴。并配苏梗、法半夏、陈皮、莱菔子消积化滞;仙鹤草、白花蛇舌草、蒲公英、黄芩清化郁热、散结消痞、解毒杀虫,其中仙鹤草一般用量为15~30g。《神农本草经》言:“牙子,主邪气,热气;疥瘙,恶疡疮;去白虫。”《百草镜》谓:“下气和血,理百病,散痞满。”《本草纲目拾遗》谓:“消宿食,散中满,下气。”仙鹤草能下气除满、清热消痞散结,缓解脘腹痞闷,胸胁胀满等症状,且能补虚强壮,增强人体正气,减少幽门螺杆菌感染机会,既切中病机,又祛除病因。

2、扶正祛邪防癌变

胃癌的形成是一个渐进性发展过程,重度萎缩性胃炎伴重度肠上皮化生、高级别上皮内瘤变可称为癌前病变。因此在癌变前及时治疗,防患于未然,极为重要。

周师认为胃癌前病变病机总属本虚标实。脾胃素虚,正气不足是其本,瘀毒蕴结为其标。毒邪可见热毒、湿毒。热毒侵及脾胃,日久伤津耗液,导致脾胃阴虚;湿毒易困脾胃,胃失受纳腐熟,脾失健运,气血生化乏源,则脾胃虚弱益甚,正虚毒恋,迁延日久,酿生痰瘀,痰瘀不化,则生癌毒。治疗上组方多以益气扶正,健脾化湿,祛痰散结,活血通络,解毒抗癌为主。常用太子参、麦冬、山药、茯苓等益气养阴扶正,薏苡仁、半夏、莪术、浙贝母、参三七等化湿祛痰散结、活血通络,仙鹤草、白花蛇舌草、半枝莲清热解毒抗癌。

现代研究表明仙鹤草中的仙鹤草鞣酸、仙鹤草素和鹤草酚是抗肿瘤的活性成分,可抵抗和吞噬肿瘤细胞,尤其对消化道肿瘤细胞有较强的抑制作用,且不损害正常细胞,反而增强机体的免疫力。肿瘤后期或癌毒术后尚属中医“虚劳”,多正气亏虚,余邪未尽。仙鹤草又名“脱力草”,“主邪气”,寓意补虚强壮,对于正气亏虚,癌毒蕴结的患者尤为适宜。周师每遇此类案例多将仙鹤草用到30g,一则祛邪抗毒,清化郁热,二则扶正补虚,未病先防,可谓攻补兼施,防治并济。

3、清肠化湿善止痢

溃疡性结肠炎临床主要表现为腹痛腹泻,利下粘液脓血便。属中医“泄泻”、“痢疾”范畴。周师认为本病脾虚为本,湿蕴大肠为标,属于虚实寒热错杂之证,病程迁延,难以速愈。治疗除用党参、白术、茯苓、薏苡仁健脾化湿;黄芩、赤芍、马齿苋解毒止痢之外,必然配用仙鹤草。《葛祖方》谓狼牙草疗“肠风下血,崩痢”,方中仙鹤草既能清化湿热,凉血解毒止痢,又能止血,补虚,对有粘液脓血便、久泄体虚者尤为适宜。

4、清热降逆抑反流

胃食管反流病系胃内容物反流入食管,引起胸骨后烧灼感或疼痛,吞酸,咽部不适,恶心等症状的一种疾病,归属于中医“泛酸”、“吐酸”等范畴。《内经》云:“诸呕吐酸…皆属于热。”《丹溪心法·吞酸》云:“平时津液随上升之气郁积而久,湿中生热,故从火化,遂作酸味。”周师认为该病常见病机为肝胃郁热,日久则耗伤胃阴。治疗除用川连、吴茱萸、乌贼骨清热制酸止呕,法半夏、陈皮、薏苡仁化湿和胃,太子参、茯苓、白术、山药、麦冬益气养阴之外,常配仙鹤草治疗反流引起的咽部烧灼感、胸骨后疼痛,疗效甚佳。其性微寒而不败胃,清热不伤阴,起到降逆,止呕,利咽之功。

胡玉翠,周晓波

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