“天人相应”顺时论治结肠息肉术后胃痞案
“Correspondence between Man and Nature” Guided Seasonal Treatment of Postoperative Gastric Stuffiness after Colon Polypectomy

本文通过分析一则结肠息肉术后胃痞验案，深度探究中医“天人相应”与“因时制宜”的诊疗智慧。本案以“脾虚气滞”为核心病机，贯穿始终，兼夹湿、热、瘀。医者之妙，在于将“辨证”与“辨时”结合：于芒种暑湿，则清利与健脾并施；于夏至阳盛，则护阳与化湿兼顾；于长夏湿困，则实脾以御邪；于霜降秋燥，则培土以生金。全案理法方药谨遵“天人相应”之旨，彰显中医整体观念与“顺时论治”之临床实效与圆融活法。
This article aims to explore the diagnostic and therapeutic wisdom of the Traditional Chinese Medicine (TCM) principles of “Tian-Ren Xiang-Ying” (Correspondence between Man and Nature) and “Yin-Shi Zhi-Yi” (Treatment according to Time) through a clinical case report of Pi-syndrome, or epigastric fullness, following colon polypectomy. The core pathogenesis of this case, consistent throughout, was identified as “spleen deficiency and Qi stagnation”, complicated by dampness, heat, and blood stasis. The physician’s art lay in the harmonious integration of pattern differentiation and temporal differentiation: during Mangzhong (Grain in Ear) with its summer-heat and dampness, the approach was to clear and drain while fortifying the Spleen; during Xiazhi (Summer Solstice) with abundant Yang-qi, the focus was to protect Yang and transform dampness; during Changxia (Late Summer) with encumbering dampness, the treatment aimed to strengthen the Spleen to resist pathogenic factors; and during Shuangjiang (Frost’s Descent) with autumn-dryness, the principle was to bank up the Earth—the Spleen—to consolidate the root. The entire case, including its principles, methods, and herbal formulas, strictly adhered to the “Tian-Ren Xiang-Ying” doctrine, vividly demonstrating the holistic concept of TCM and the clinical efficacy and profound wisdom of “Shun-Shi Lun-Zhi” (Chrono-treatment).