从鼓胀的病机、治疗原则、分型施治总结国医大师颜德馨（尊称颜老）辨治鼓胀的临床经验。颜老认为，鼓胀的病证 特点为本虚标实，基本病机为肝、脾、肾三脏功能失调，气滞、血瘀、水饮互结于腹中，主要可分为湿热壅结、寒湿停聚、 瘀滞内阻证型，其治则为温肾助阳以复气化、健运中州、疏通气机。湿热壅结之鼓胀治宜清热利湿，抑肝扶脾；寒湿停聚 之鼓胀治疗当斡旋中阳，祛除寒湿；瘀滞内阻之鼓胀治以活血化瘀、搜络破结。并附笔者临证医案一则以阐释颜老辨治鼓 胀之思路对临证的启示。

This article summarized the clinical experience of Yan Dexin， a master of traditional Chinese medicine， in differentiating and treating abdominal distention， in terms of its pathogenesis， therapeutic principles， differentiation of syndrome types and treatment. Master Yan believes that the pathogenesis of abdominal distention is characterized by deficiency in origin and excess in superficiality. Its fundamental pathogenesis is due to the dysfunction of liver， spleen and kidney， which results into the accumulation of qi stagnation，blood stasis，and fluid retention in the abdomen. The syndrome differentiation of abdominal distention can be mainly categorized into damp-heat accumulation type，cold-damp retention and accumulation type，and internal obstruction of stasis and stagnation type. The therapeutic principle is to warm kidney yang for the recovery of qi transformation，invigorate middle energizer and promoting qi movement. For the treatment of abdominal distention of damp-heat accumulation syndrome type，therapies of clearing heat and draining dampness，suppressing the liver and strengthening the spleen are suggested；for the treatment of abdominal distention of cold-damp retention and accumulation type，therapies of mediating middle-yang and eliminating cold-damp can be adopted；for the treatment of abdominal distention of internal obstruction of stasis and stagnation type，therapies of activating blood to remove stasis，unblocking the collaterals and dissipating mass are recommended. A proven medical case was presented for the analysis of the inspiration of Master Yan’s thinking on the treatment of abdominal distention.

R256.42

上海市卫计委科学技术专项研究课题面上项目（编号：2020LZ001）；上海市公共卫生临床中心资助课题（编号：KY-GW-2025-32）