基于“开阖枢”理论探讨逍遥散治疗肝郁脾虚型儿童矮身材

Exploring the therapeutic effects of Xiaoyao powder on short stature in children with liver depression and spleen deficiency based on the "Opening-Closing Pivot" theory

摘要

开阖枢是中医核心生理调控理论, 太阳、太阴主“开”, 司精微布散、津液运化；阳明、厥阴主“阖”, 主水谷腐熟、精血固藏；少阳、少阴主“枢”, 为沟通开阖、协调气机的核心。三者协同维系脏腑气机升降与精微输布, 是儿童生长发育的关键机制。肝郁脾虚型儿童矮身材, 因小儿肝常有余、脾常不足, 易受情志影响致少阳枢机郁滞, 木郁克土, 进而引起太阴开阖失序、阳明阖机失调, 兼肝血亏虚, 最终气血生化乏源、筋骨失养而生长迟缓。逍遥散以柴胡、佛手疏少阳调枢, 白术、茯苓、炙甘草健太阴复开, 煨生姜配佛手和阳明助阖, 当归、白芍养厥阴补血, 全方调枢、复开、助阖、养血, 肝脾同调、气血互生, 精准契合开阖枢失调病机, 为治疗肝郁脾虚型矮身材的有效方剂。

Abstract

The "Opening-Closing Pivot" theory constitutes a core physiological regulation theory in traditional Chinese medicine. The Taiyang and Taiyin meridians govern "opening", overseeing the dispersion of nutrients and fluid metabolism; the Yangming and Jueyin meridians regulate "closing", managing food digestion and essence-blood storage; the Shaoyang and Shaoyin meridians control "pivot", serving as the core of coordinating qi dynamics and facilitating opening and closing. The synergistic action of the three maintains visceral qi circulation and nutrient distribution, forming a critical developmental mechanism in children. Children with liver depression and spleen deficiency often exhibit short stature due to inherent liver excess and spleen deficiency, which may lead to emotional disturbances and cause Shaoyang pivot stagnation. The stagnated Wood restrains Earth, disrupting Taiyin's opening-closing balance and Yangming's closing mechanism, which, combined with liver-blood deficiency, ultimately compromises the capacity of qi-blood production and impairs musculoskeletal nourishment, resulting in growth retardation. Xiaoyao powder soothes the Shaoyang meridian to regulate the pivot with bupleurum and fingered citron, strengthens the Taiyin meridian to restore opening with Atractylodes macrocephala, Poria and fried Licorice, harmonizes Yangming to assist closing with stewed ginger combined with fingered citron, and nourishes Jueyin to nourish blood with Angelica sinensis and white peony root. The entire formula regulates the pivot, restores opening, assists closing, and nourishes blood, achieving harmonious coordination between liver and spleen as well as mutual generation of qi and blood. It precisely targets the pathogenesis of dysregulation of opening, closing and pivot, making it an effective prescription for treating short stature with liver depression and spleen deficiency.

关键词

矮身材 / 肝郁脾虚 / 开阖枢 / 逍遥散 / 儿童

Key words

Short stature / "Opening-Closing pivot" theory / Xiaoyao powder / Child

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