徐建萍 杨若俊 许峻 陈帅

摘要：厌食症是儿科常见的慢性食欲障碍性疾病，长期厌食对儿童营养状况、生长、智力发育及身心健康易造成不良影响。云南中医学院国家级名老中医刘以敏教授治疗此病颇具心得，认为其病机关键为脾胃失和、运化无力，临证从食滞胃腑、脾为湿困、脾胃气虚、脾弱肝旺4个方面辨治本病，法以消食导滞、健脾除湿、健脾益气、健脾平肝为主，常用焦三仙与鸡内金、车前子与山药、红土瓜与兰花参、荠菜花与菊花等药对治疗，取得较好临床疗效。

关键词：名医经验；刘以敏；厌食症；儿童；药对

DOI：10.3969/j.issn.1005-5304.2017.09.028

中图分类号：R272.957 文献标识码：A 文章编号：1005-5304（2017）09-0108-03

Professor LIU Yi-mins Treatment for Infantile Anorexia and Commonly Used TCM Pairs XU Jian-ping， YANG Ruo-jun， XU Jun， CHEN Shuai （Clinical Medical College of Yunnan University of Traditional Chinese Medicine， Kunming 650500， China）

Abstract： Anorexia is a common pediatric and multiple chronic appetite disorder disease. Long-term anorexia can easily lead to adverse effects on nutritional status， growth， intellectual development and physical and mental health of children. Professor LIU Yi-min， the national famous TCM doctor in Yunnan University of Traditional Chinese Medicine， has much experience in treating this disease， believing that the pathogenesis key is spleen and stomach disharmony and inability to transport. According to clinical experience， it should be treated from indigestion of stomach， spleen dampness， spleen qi deficiency， and spleen weakenness and liver excess. The treatment is to eliminate indigestion， tonify spleen and expel humidity， tonify spleen and nourish qi， and tonify spleen and harmonize liver. The commonly used TCM pairs were Charred Triplet and Galli Gigerii Endothelium Corneum， Plantaginis Herba and Dioscoreae Rhizoma， Hungaian Morningglory Root and Marginate Rockbell Herb and Capsella bursa-pastoris and Chrysanthemi Flos.

Key words： experience of famous doctors； LIU Yi-min； anorexia； children； medical pairs

劉以敏教授为全国老中医药专家学术经验继承指导老师、云南省荣誉名中医，师承云南四大名医之一的儿科名家康诚之先生，后又得到上海中医药大学王玉润教授的指导。刘老从医数十年，集各家所长，积累了丰富的临床经验，其丰厚的学术造诣与临床经验，形成了独特的学术理论，对脾、肺、肾相关疾病与儿科疑难杂症颇具心得，尤其对小儿常见的厌食症具有较好临床疗效，现将刘老相关用药经验总结如下。

1 辨治思路

刘老认为，厌食症的病变脏腑在脾胃，正如《灵枢·脉度》云：“脾气通于口，脾和则口能知五谷矣。”故其病机关键为脾胃失和，运化无力。

通讯作者：杨若俊，E-mail：yrj215@163.com

1.1 食滞胃腑

脾为脏，胃为腑，两者一阴一阳互为表里而为用。胃主受纳，以降为顺，传化物而不藏。现代社会由于食物丰富，家长片面强调营养，不顾儿童脾胃功能强弱，给予大量膏粱厚味之品，忽略了其脾胃的吸收能力，导致饮食宿食积滞胃腑，胃腑无力受纳，脾无力运化而致饮食不化，口不知味。……