妇科腹部手术后早期肠麻痹的辨治思路探析  

Preliminary study on the syndrome differentiation and treatment of postoperative ileus after a gynecological abdominal operation

作　　者：徐道立 陈振振[3,4] 贡欣 Xu Daoli;Chen Zhenzhen;Gong Xin(Beijing University of Chinese medicine,Beijing 10029;Dongfang Hospital of Beijing University of Chinese medicine;School of TCM,Capital Medical University;Beijing Key Laboratory of Collateral Disease of Traditional Chinese Medicine)

机构地区：[1]北京中医药大学,北京100029 [2]北京中医药大学东方医院妇科 [3]首都医科大学中医药学院 [4]中医络病研究北京市重点实验室

出　　处：《现代中医临床》2021年第2期68-71,共4页Modern Chinese Clinical Medicine

基　　金：首都卫生发展科研专项项目(No.首发2018-4-4204)。

摘　　要：术后早期肠麻痹(postoperative ileus, POI)是指腹部或非腹部手术后,因胃肠道动力改变,不能有效传输胃肠道内容物,以恶心、呕吐、腹胀和排气排便延迟等为主要临床表现的临床症候群。脾胃失和为腹部手术POI的基本病机,冲任虚损是主要病机特点。脾胃之病和则健、不和则病,针对POI脾胃失和的基本病机,临床治疗应选择和法。中气得和,则上下得通,脾升胃降,腑气得通。妇科腹部术后POI患者冲任虚损,为虚实夹杂证,其中虚体现为冲任气血不足,损则为金刃动及胞宫,伤及冲任,导致血瘀邪实。治疗时注重虚实夹杂的病理本质,采用祛瘀生新、健运脾胃的治法,促进胃肠及冲任功能恢复。Postoperative ileus(POI) is a syndrome that fails to effectively transmit gastrointestinal contents due to changes in gastrointestinal motility after an abdominal or non-abdominal surgery. The main clinical manifestations are nausea, vomiting, abdominal distension and delayed exhaust and defecation.In traditional Chinese medicine, disharmony of the spleen and stomach is the basic pathogenesis of POI in abdominal surgery, and Chong Ren deficiency is the main pathogenesis. Accordingly, as for its clinical treatment, the harmonizing method is suggested.If the Middle Qi is harmonious, the upper and lower parts of the body will be unblocked, the spleen(qi) will ascend and the stomach qi will descend, and the Bowel Qi will be unblocked. Chong and Ren will be hurt in patients with POI after a gynecological abdominal surgery, which is the syndrome of both deficiency and excess, in which deficiency is embodied in deficiency of Chong Ren’s Qi and blood;excess is the medal blade cutting the uterus, which hurts Chong and Ren, leading to blood stasis. As for the treatment, we should pay attention to the pathological essence of deficiency and excess, and adopt the methods of removing blood stasis and promoting the spleen and stomach to promote the recovery of gastrointestinal and Chong Ren functions.

关 键 词：术后早期肠麻痹 排便 腹胀 脾胃失和 冲任虚损 和法 调补冲任 消化系统 

分 类 号：R271.9[医药卫生—中西医结合]