Sjogren syndrome（SS） is a clinically refractory autoimmune disease characterized by multi-system, multi-organ damage.Professor Liu believes that the occurrence and development of SS is closely related to the five-zang organs.The weakness of spleen and stomach and dysfunction of spleen transportation are the fundamental causes of SS.Stagnation of liver qi and failure of store and excretion are important pathogenic factors of SS.The lung fails to disperse and purification and lung yin deficiency are important causes of SS.The heart lack of regulation and nourishment, obstruction due to blood stagnation are the main disease causes.Deficiency of kidney yin and yang are the key to the long-term difficult to recover of SS.The spleen and stomach, as the hub of qi movement and the source of qi and blood biochemistry, are particularly important for SS.If the spleen and stomach are safe, the zang-fu viscera are full of body fluids, and the body is moistened.Otherwise, the biochemical power is not right, and the dryness is endogenous, leading to the occurrence or aggravation of SS.In clinical treatment, it is suggested to regulate the five-zang organs, regulate the spleen and stomach, and guide the clinical treatment of SS,which can achieve good effect.

胃食管反流病(gastroesophageal reflux disease,GERD)是消化系统中的常见病与难治性疾病,症状繁杂,迁延难愈.笔者从"诸气膹郁,皆属于肺"(《素问·至真要大论篇》)的角度出发,探讨全国名中医刘启泉教授从肺辨治GERD的证治思路与用药特色.刘启泉教授认为GERD总以气机失调为基本病机,临证将此病病机特点总结为气(肺胃气逆)、湿(湿滞肺脾)、热(肺胃郁热)、虚(肺胃阴虚),提出了降、宣、清、养四大治法,即:降肺以调胃腑通降,佐斡旋气机;宣肺以辅脾气升清,助运化水湿;清肺以散肺胃郁热,平升降之路;养肺以滋肺胃阴液,厘津亏虚热.刘启泉教授主张以顺气为先、调中为要、兼顾滋阴,旨在燮理气机、开通郁结、调肺安胃、升降有常;在辨证施治的基础上,其用药特色包括慎用开破、妙用轻灵、酌加苦寒、巧佐理气之品等;总以化裁复衡、以调求平为调摄目标,并嘱患者调畅情志、药食并重.刘启泉教授临证中圆机活法,常得佳效,其辨治经验可为临床相关诊疗拓宽思路.

Professor Liu Qiquan believes that dry eye is closely related to the five zang-organs, that when the body feels pathogens and dysfunction of the viscera occurs will affect the function of the eye, and the develops into dry eye. The pathogenesis can be summarized as: dysfunction of the spleen in transportation and failure of stomach qi to descend are the root for the incidence of dry eye; impairment of the purifying and descending function of the lung,and lung yin deficiency are the important trigger of dry eye; kidney yang deficiency and kidney yin deficiency are the key to the difficulty in healing; liver yin deficiency and wind-heat attack are the important pathogenic factors of dry eye; heart deficiency and flaring of heart fire are the main causes of dry eye. Spleen and stomach as the postnatal foundation. If the spleen and stomach are healthy, the nutrients of the zang-organs can be transported upward; if the spleen and stomach are in the dysfunction, the nourishment is not produced, the eyes lose nutrients and it will cause dry eye. Therefore, the methods of “Ru Mu”, “Zi Mu”, “Run Mu”, “Shuang Mu”, “Yang Mu” are used in clinic based on the theory of “calm spleen and stomach”, which can achieve the purpose of harmony of five zang-organs and normal eye function.

刘启泉教授在消化性溃疡的治疗上见解独到,认为本病病机与心相关,临证中从心出发选方用药,治法包括清热解毒除心火、补气化瘀通血脉和疏肝定痛安心神,并附病案1则,以资佐证.

认为多汗症与五脏功能失常有关,脾胃不和是其关键病机,提出从"通调五脏安脾胃"观点辨治多汗症.临证自拟安脾胃经验方作为基础方以健脾和胃止汗,同时根据多汗症不同的症状表现辨证论治.针对心、肺、肾、肝四脏功能失常所致的多汗症,心病者配合养心清心法以敛汗,常合用桂枝甘草汤或当归六黄汤加减;肺病者配合益肺泻热法以固汗,常合用玉屏风散或泻白散加减;肾病者配合补肾滋阴法以摄汗,常合用金匮肾气丸或都气丸加减;肝病者配合清肝敛肝法以束汗,常合用龙胆泻肝汤或一贯煎加减.使五脏调和,阴平阳秘,肌表得固,多汗症得瘥.

刘启泉主任中医师发挥中医象思维的优势,取镜下幽门螺旋杆菌(Hp)之象类比"虫"之态,认为导致Hp相关性胃炎(HPAG)的特定邪气可归属于"虫邪".并针对虫性喜甘、恶酸、怕苦、惧辛的特性,提出"药性屠虫"的治疗策略,临证倡导"酸甘合用,软虫缓中""苦寒相合,伏虫去湿""油补同施,杀虫扶正",屡有效验.

慢性萎缩性胃炎是临床常见的脾胃疾病.刘启泉教授认为脾与胃虽有协同作用,但二者各司升降、纳运有别、喜恶不同,在慢性萎缩性胃炎发生发展的过程中,主病位不同,治则治法应随之不同,提出"脾胃分治".治疗上,刘教授倡导圆机活法,巧用药性,配伍精当,治脾以风药清扬升脾气、芬芳善行助脾运、补中有动温脾阳;治胃以对药和降调胃气、甘寒为用清胃热、清润安中养胃阴、角药缓图通胃络.以上诸法在"脾胃分治"的理论指导下灵活取用,疗效显著.

提要研究全国名中医刘启泉主任医师基于"土滞"治疗腹泻型肠易激综合征(IBS-D)经验.IBS-D是一种常见的身心疾病,近年来发病率呈逐年增多趋势,临床表现为腹泻、排便习惯的改变等.其发病多与脑肠轴功能紊乱、下丘脑-垂体-肾上腺皮质轴亢进、肠道菌群失调等因素相关.刘师认为IBS-D病位在大肠,脾虚为发病之根本,"土滞"为本病的关键病机,并且与肺肝肾密切相关,以脾胃为侧重点,兼顾肺肝肾,治以运脾化湿、疏肝清气、宣肺敛肠、补益脾肾之法,疗效满意.