無胃口食野 2017-10-26 林小珊博士
![無胃口的圖片搜尋結果](data:image/jpeg;base64,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)
林小珊醫師的【懸壺手記】中醫專欄隔周四刊登於信報,歡迎查閱
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林小珊醫師的【懸壺手記】中醫專欄隔周四刊登於信報,歡迎查閱
![](https://www.facebook.com/images/emoji.php/v9/f28/3/16/1f46f_200d_2640.png)
無胃口食野 林小珊博士
“民也食為天”,餓了能吃,困了能睡,是生而為人最正常不過的事也。然而,並非每個人都可以得天獨厚,食得訓得。筆者在臨床上望聞問切過程中,每每問及病人胃口的時候,有一部分人就有“無胃口食野”的困擾。
他們“無胃口食野”的形式層出不窮,有的是整天都沒有食慾,到了用餐時間也沒有想吃點東西的感覺;有些則是該吃飯的時間了,所以把眼前的食物嚥下去,維持身體一日所需,至於吃下去的是什麼,自己到底那頓飯想吃什麼,倒是隨隨便便,並不講究。
中醫看待這個“無胃口食野”,咱們一般歸納在脾胃不好,常見是脾虛濕盛型、脾陽虧虛型和胃陰不足型。這些患者,有些是先天脾胃本來就比較虛弱,從小就不愛吃飯,有偏食習慣,容易消化不良,然而,更多的人是在後天生活工作中不注意飲食,養成不良的飲食習慣,食無定時,餐貧餐富,偏嗜某些食物,如辛辣煎炸、肥甘厚味、冰冷寒涼之品,或過甜過咸,於是在不知不覺中破壞了脾胃的正常受納、腐化水谷精微的功能,除了無胃口食野這個症狀外,還可能出現形體消瘦或虛胖水腫、面色萎黃,精神疲憊,有氣無力,頭暈腳浮等症狀。所以說,日常生活小事不要看輕,掉以輕心,一些細微的壞習慣一旦形成了,所造成的結果和影響並非一朝一夕可以彌補的。
脾虛濕盛型的患者除了上述一派脾氣虧虛的表現之外,還有濕重的表現。那麼,什麼是濕重的表現呢?大家可以想像在潮濕炎熱的夏天,人覺得鬱悶困頓,精神不振,身體手腳困重,大便溏爛等症狀,這些都是濕所造成的,分別只是由外濕或是內濕所造成。因為脾主運化,脾的運化水谷精微功能失常,身體水液不能如常四佈,灌溉全身,異常地堆積在不應該堆積的身體部位,如在四肢則表現手腳困重,如在頭部則見頭暈,在大腸則表現為大便溏爛。治療上要標本兼治,既健脾又要祛濕。茨實、茯苓、薏米和淮山等可以多服。
脾陽虧虛型的患者則除了在脾虛表現以外,兼有脾陽虛的症狀。所謂陽虛,就是陽氣不足,所以表現一派虛寒症狀。例如沒有胃口,吃幾啖以後就沒有食慾,手腳冰冷,說話陰聲細氣,腹痛腹瀉等等。因為缺了“一把火”,脾胃腐熟水谷的功能減弱,生米很難煮成熟飯,所以比較容易見到腹瀉的表現。治療上強調溫運脾陽。乾薑、厚樸、神曲和花椒乃不錯的用藥。
至於胃陰不足的納差患者,則較容易看到乾燥和燥熱的症狀。比方說口乾舌燥,噯氣泛酸,大便乾結,皮膚乾燥等,治療上需滋陰健脾。北沙參、麥冬、玉竹和淮山等為常用中藥。
具體証型和治療還是因人而異,而且沒有一個人的症狀和用藥會完全相同,即是同一個人,在不同時間、不同氣候和季節,所用處方亦不相同。在秋天瓜熟蒂落的豐收好時節,祝大家胃口常開!
作者為註冊中醫師
www.facebook.com/lamsiushan
他們“無胃口食野”的形式層出不窮,有的是整天都沒有食慾,到了用餐時間也沒有想吃點東西的感覺;有些則是該吃飯的時間了,所以把眼前的食物嚥下去,維持身體一日所需,至於吃下去的是什麼,自己到底那頓飯想吃什麼,倒是隨隨便便,並不講究。
中醫看待這個“無胃口食野”,咱們一般歸納在脾胃不好,常見是脾虛濕盛型、脾陽虧虛型和胃陰不足型。這些患者,有些是先天脾胃本來就比較虛弱,從小就不愛吃飯,有偏食習慣,容易消化不良,然而,更多的人是在後天生活工作中不注意飲食,養成不良的飲食習慣,食無定時,餐貧餐富,偏嗜某些食物,如辛辣煎炸、肥甘厚味、冰冷寒涼之品,或過甜過咸,於是在不知不覺中破壞了脾胃的正常受納、腐化水谷精微的功能,除了無胃口食野這個症狀外,還可能出現形體消瘦或虛胖水腫、面色萎黃,精神疲憊,有氣無力,頭暈腳浮等症狀。所以說,日常生活小事不要看輕,掉以輕心,一些細微的壞習慣一旦形成了,所造成的結果和影響並非一朝一夕可以彌補的。
脾虛濕盛型的患者除了上述一派脾氣虧虛的表現之外,還有濕重的表現。那麼,什麼是濕重的表現呢?大家可以想像在潮濕炎熱的夏天,人覺得鬱悶困頓,精神不振,身體手腳困重,大便溏爛等症狀,這些都是濕所造成的,分別只是由外濕或是內濕所造成。因為脾主運化,脾的運化水谷精微功能失常,身體水液不能如常四佈,灌溉全身,異常地堆積在不應該堆積的身體部位,如在四肢則表現手腳困重,如在頭部則見頭暈,在大腸則表現為大便溏爛。治療上要標本兼治,既健脾又要祛濕。茨實、茯苓、薏米和淮山等可以多服。
脾陽虧虛型的患者則除了在脾虛表現以外,兼有脾陽虛的症狀。所謂陽虛,就是陽氣不足,所以表現一派虛寒症狀。例如沒有胃口,吃幾啖以後就沒有食慾,手腳冰冷,說話陰聲細氣,腹痛腹瀉等等。因為缺了“一把火”,脾胃腐熟水谷的功能減弱,生米很難煮成熟飯,所以比較容易見到腹瀉的表現。治療上強調溫運脾陽。乾薑、厚樸、神曲和花椒乃不錯的用藥。
至於胃陰不足的納差患者,則較容易看到乾燥和燥熱的症狀。比方說口乾舌燥,噯氣泛酸,大便乾結,皮膚乾燥等,治療上需滋陰健脾。北沙參、麥冬、玉竹和淮山等為常用中藥。
具體証型和治療還是因人而異,而且沒有一個人的症狀和用藥會完全相同,即是同一個人,在不同時間、不同氣候和季節,所用處方亦不相同。在秋天瓜熟蒂落的豐收好時節,祝大家胃口常開!
作者為註冊中醫師
www.facebook.com/lamsiushan
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