调神益胃针刺法治疗胃癌术后胃肠功能障碍的验案  

A case study of Tiaoshen Yiwei acupuncture in the treatment of gastric cancer postoperative gastrointestinal dysfunction

作　　者：王佳琪 王旭慧[1,2] 吴帮启 WANG Jiaqi;WANG Xuhui;WU Bangqi

机构地区：[1]天津中医药大学第一附属医院,天津300000 [2]国家中医针灸临床医学研究中心,天津300000

出　　处：《中医临床研究》2024年第12期103-105,共3页Clinical Journal Of Chinese Medicine

摘　　要：胃癌是一种病死率较高的恶性肿瘤,其起病隐匿,易被忽视,容易错过最佳治疗时机。研究证明不良的生活习惯及极大的心理压力均会使胃癌的患病风险增高。随着医学的不断进步,早期手术切除部分胃部可延长患者的生存周期,但术后并发症的治疗也不容忽视。其中,胃肠功能障碍、反流性食管炎都是常见的并发症。切除部分胃部影响了胃的蠕动功能,残胃的胃腺壁细胞继续分泌胃酸,胃酸反流进入食管内将破坏食管黏膜,使食管持续性处于痉挛状态,增加反流性食管炎的发生风险。临床常用促胃动力药、抑酸药治疗,但疗效欠佳。中医学中,胃癌归属于“反胃”“胃痛”“噎膈”等范畴。胃癌术后并发症以脾胃虚损,正气不足为主,正气无力抗邪,以致痰浊、瘀血、邪毒内生。疾病的长期困扰、生活方式的改变对患者的情绪也造成极大打击。笔者基于“脑-肠轴”学说,选取足阳明胃经及任脉、督脉上的穴位,共奏调神益气,健脾和胃之功,双向调节胃肠系统及中枢神经系统。在进行针刺治疗的同时,对患者进行心理疏导,指导他们选择正确的生活方式,外治与内调紧密结合,起效快且无不良反应,实现脑与胃肠同治的目的,故记录于案,为胃癌术后胃肠功能障碍的治疗提供新的思路。Gastric cancer is a kind of malignant tumor with high mortality,which has an insidious onset and is easy to be neglected,thus missing the best time for treatment.Studies have shown that poor lifestyle habits and great psychological stress can increase the risk of stomach cancer.With the continuous progress of medicine,early surgical resection of part of the stomach can prolong the survival cycle of patients,but the treatment of postoperative complications should not be neglected.Among them,gastrointestinal dysfunction and reflux esophagitis are all common complications.Resection of part of the stomach affects the peristaltic function of the stomach,the gastric gland wall cells of the residual stomach continue to secrete gastric acid,and the reflux of gastric acid into the esophagus will destroy the esophageal mucosa,make the esophagus in a persistent spasm and increase the risk of reflux esophagitis.Gastric motility drugs and acid suppressive drugs are commonly used in clinical treatment,but the effect is not good.In traditional Chinese medicine,gastric cancer is classified as“regurgitation”,“stomach pain”,“choking diaphragm”and so on.Postoperative complications of gastric cancer are mainly due to deficiency of spleen and stomach,and deficiency of healthy Qi(气),which leads to turbidness of phlegm,blood stasis and endogenous pathogenic toxin.The long-term distress of the disease and the change of lifestyle have also caused a great blow to the patients’emotions.Based on the theory of“Brain-Gut Axis”,the author selects the Yangming(阳明)Stomach Meridian of foot,Conception Vessel and Governor Vessel to regulate the spirit and replenish Qi,strengthen the spleen and stomach,and regulate the gastrointestinal system and central nervous system in both directions.On the basis of acupuncture treatment for patients,psychological counseling is given to patients to guide them to choose the right way of life.External treatment is closely combined with internal regulation,with rapid effect and no adverse re

关 键 词：针刺 调神 胃癌术后 胃肠功能障碍 验案 

分 类 号：R273[医药卫生—中西医结合]