从“中气下陷”探讨直肠脱垂的病机  

Discussion on the pathogenesis of rectal prolapse from “middle qi collapse”

作　　者：周娇娇[1] 陈琴[1] 李宇飞[1] 王晓锋[1] 崔国策[2] 李华山[1] ZHOU Jiaojiao;CHEN Qin;LI Yufei;WANG Xiaofeng;CUI Guoce;LI Huashan(Department of Anorectal,Guang′anmen Hospital,China Academy of Chinese Medical Sciences,Beijing100053,China;Department of Anorectal,Southern Branch of Guang′anmen Hospital,China Academy of Chinese Medical Sciences,Beijing102618,China)

机构地区：[1]中国中医科学院广安门医院肛肠科,北京100053 [2]中国中医科学院广安门医院南区肛肠科,北京102618

出　　处：《中国医药导报》2020年第2期120-123,共4页China Medical Herald

基　　金：国家自然科学基金资助项目(81673988、81673980)

摘　　要：本文为加深“中气下陷”对直肠脱垂相关病机的认识,分别从祖国医学和现代医学两个方面进行阐述,以期更好地指导临床,同时也为科研工作中直肠脱垂的造模指明方向。在祖国医学中,“中气下陷”通常指因脾气虚导致组织弛缓不收、脏器脱垂的一类病证,说明“中气下陷”与直肠脱垂的发病直接相关。在现代医学中,直肠脱垂病机是直肠黏膜松弛或直肠与周围的支持组织发生松弛分离,直肠失去支撑而滑脱下移,与祖国医学的认知基本一致;关于人工直肠脱垂模型建立的实验研究,久泻的造模方法与祖国医学的认识不谋而合;此外,直肠脱垂常见于fibulin-5基因缺陷小鼠、免疫功能低下的转基因小鼠或结肠炎小鼠等虚弱的小鼠,亦符合祖国医学中“气虚不能固,而下脱也”的描述,即间接说明直肠脱垂的病机与“中气下陷”理论有关。In order to deepen the understanding of the pathogenesis of rectal prolapse in“middle qi collapse”,this paper expounds the two aspects of traditional Chinese medicine and modern medicine,in order to better guide the clinical practice,and also to point out the direction for the modeling of rectal prolapse in scientific research.In traditional Chinese medicine,“middle qi collapse”usually refers to a kind of disease,which is caused by qi deficiency,such as tissue relaxation and organ prolapse,indicating that“middle qi collapse”is directly related to the incidence of rectal prolapse.In modern medicine,the pathogenesis of rectal prolapse is the relaxation of rectal mucosa or the relaxation and separation of the rectum and its surrounding supporting tissue,and the rectum loses its support and slides down,which is basically consistent with the cognition of traditional Chinese medicine;as well as the experimental research on the establishment of artificial rectal prolapse model,the modeling method of chronic diarrhea coincides with the cognition of traditional Chinese medicine;in addition,rectal prolapse is common in fibulin-5 the weak mice,such as gene deficient mice,transgenic mice with low immune function or colitis mice,are also in line with the description of“qi deficiency can not be fixed,but it also falls off”,which indirectly indicates that the pathogenesis of rectal prolapse is related to the theory of“middle qi collapse”.

关 键 词：中气下陷 直肠脱垂 病机 直肠脱垂模型 

分 类 号：R657.1[医药卫生—外科学]