谈利小便实大便

“利小便实大便”是中医重要的治疗方法之一。下焦主分清浊,下利者,水谷不分也;三焦湿郁,升降失司,脘连腹胀,大便不爽。临床上利小便实大便,一方面不仅治疗大便泄泻,同时也治疗大便黏腻不爽,使二便分消,水湿从小便而去。五苓散渗湿利水,温阳化气,治疗便溏;一加减正气散化湿和中,理气健脾,治疗大便不爽。本文结合治疗慢性腹泻和糖尿病的病例,论述利小便实大便理论在临床上的应用。但久泻不可纯利小便,温病利小便宜甘苦合化阴利小便。

Discussion on Treating Diarrhea by Inducing Diuresis

"Treating diarrhea by inducing diuretics" is one of the important treatment methods of traditional Chinese medicine. Xiajiao distributes pure and turbid, and the water and cereals in diarrhea patients are mixed. Sanjiao is wet depression and not lifting, result in abdominal fullness and distention, even ungratifying defecation. Clinically, this concept not only can be used in treating diarrhea, but also in the treatment of ungratifying defecation, making the stool and urine excrete, wet from the urine. Wuling powder eliminates dampness and diuresis, warms Yang and promotes flow of Qi to treat loose stool;Yijiajian Zhengqi powder removes dampness for regulating stomach and regulates Qi-flowing for strengthening spleen to treat ungratifying defecation.This paper discusses the theory of treating diarrhea by inducing diuretics in clinical application by combining the treatment of chronic diarrhea and diabetes cases. But long diarrhea is not probable for only inducing urinate, patients with warm disease should induce diuretic with sweetness and bitternessturn to Yin.