“肺胃同治”理论在肺癌术后胃瘫综合征中的运用探析  

Analysis of the theory of"simultaneous treatment of lung and stomach"in postsurgical gastroparesis syndrome of lung cancer

作　　者：张阿润 许绍典 刘传波[3] 胡凯文[3] ZHANG Arun;XU Shaodian;LIU Chuanbo;HU Kaiwen(Beijing University of Chinese Medicine,Beijing 100105,China;Xuanwu Hospital of Capital Medical University,Beijing 100053,China;Dongfang Hospital of Beijing University of Chinese Medicine,Beijing 100078,China)

机构地区：[1]北京中医药大学,北京100105 [2]首都医科大学宣武医院,北京100053 [3]北京中医药大学东方医院,北京100078

出　　处：《吉林中医药》2023年第8期869-873,共5页Jilin Journal of Chinese Medicine

基　　金：国家重点研发计划(2018YFC1705100)。

摘　　要：术后胃瘫综合征(postsurgical gastroparesis syndrome,PGS)多见于腹部手术后,是一种病因不明的非机械性梗阻性胃排空障碍。一般认为PGS的病因与迷走神经损伤有关,但最近有研究发现,即使患者手术前后迷走神经功能异常也不一定出现胃瘫症状,PGS是否出现临床症状可能也与其他因素有关。多项研究发现胸部手术后也会出现PGS,肺癌是最常见的恶性肿瘤之一,早期手术切除是其唯一可能治愈方法。中医认为,肺癌术后肺脏受损,致气机升降失调是肺癌PGS重要的发病因素,肺胃同治理论是治疗肺癌PGS的关键。本文从经络、藏象、病机3方面论述肺胃同治的理论基础,总结肺胃同治理论可指导治疗肺癌PGS的遣药组方,并结合临床典型病案加以阐述,为肺癌PGS的临床治疗提供新的思路。The postsurgical gastroparesis syndrome(PGS)is a non-mechanical obstructive gastric emptying disorder with unknown etiology,commonly occurring after an abdominal surgery.It is generally believed that the etiology of PGS is related to vagus nerve injury,but recent studies have found that patients with abnormal vagal function before and after surgery do not necessarily develop the symptoms of gastroparesis,and whether clinical symptoms occur in PGS may also be related to other factors.Several studies have found that PGS also occurs after a chest surgery,and lung cancer is one of the most common malignant tumors for which an early surgical resection is the only possible cure.According to traditional Chinese medicine,a disturbance in qi ascending and descending caused by impaired lung after a lung cancer surgery is an important factor for the development of lung cancer PGS,and the theory of simultaneous treatment of lung and stomach is the key to treating PGS in lung cancer.This article discusses the theoretical basis of simultaneous treatment of lung and stomach from three aspects,namely,meridians,visceral manifestations and pathogenesis,summarizing its guidance in the prescription formulation and medication for the treatment of PGS in lung cancer,and elaborating on it in combination with typical clinical cases,so as to provide new ideas for the clinical treatment of this disease.

关 键 词：肺癌 手术后胃瘫综合征 肺胃同治 中医治疗 

分 类 号：R734.2[医药卫生—肿瘤]