基于“温通三结法”探讨恶性肠梗阻中医病机及外治思路  

Exploration on Traditional Chinese Medicine Pathogenesis and External Treatment Approach of Malignant Bowel Obstruction with“Warming and Promoting Circulation of Three Junctions Method”

作　　者：刘泽豪 谢虹亭 安宸 乔塬淏 薛鹏 朱世杰[2] LIU Zehao;XIE Hongting;AN Chen;QIAO Yuanhao;XUE Peng;ZHU Shijie(Graduate School,Beijing University of Chinese Medicine,Beijing 100029,China;Oncology Department,Wangjing Hospital of China Academy of Chinese Medicine Sciences,Beijing 100102,China)

机构地区：[1]北京中医药大学研究生院,北京100029 [2]中国中医科学院望京医院肿瘤科,北京100102

出　　处：《中医肿瘤学杂志》2025年第1期72-77,共6页Journal of Oncology in Chinese Medicine

基　　金：中国中医科学院望京医院高水平中医医院建设项目(编号:WJZJ-202305,WJYY-XZKT-2023-37);中国中医科学院科技创新工程协同重点攻关项目(编号:CI2022C002-04)。

摘　　要：恶性肠梗阻作为晚期胃肠道及盆腔肿瘤的常见并发症,以慢性疼痛、腹胀、恶心、呕吐为主要临床表现,常引发患者进食服药困难,严重威胁肿瘤患者的生存及预后。同时,针对恶性肠梗阻的相关内治方法有限,而以西医外治及手术治疗的疗效欠佳。中医外治法在恶性肠梗阻的治疗中独具优势,基于多年临床实践,笔者团队认为正气虚损、腑气不通为其主要病机,阳虚为发病之因,肠腑之寒结、气结、血结为主要病理环节,故提出“温通三结”的治法,该法融合“温法”“消法”与“下法”,以温阳散积、理气消癥为主要策略,运用穴位贴敷、中药热敷和中药灌肠等外治手段,颇具临床疗效。现本文将温通三结法外治恶性肠梗阻思路报道如下。Malignant bowel obstruction,a common complication of advanced gastrointestinal and pelvic tumors,is characterized by chronic pain,abdominal distension,nausea,and vomiting.It often leads to difficulties in eating and medication of patients,seriously threatening the survival and prognosis of tumor patients.Meanwhile,the internal treatment options for malignant bowel obstruction are limited,with western medicine external treatments and surgical interventions generally yielding inferior outcomes.External treatments of traditional Chinese medicine(TCM)have unique advantages in malignant bowel obstruction.Based on years of clinical practice,the author team believes that the primary pathogenesis of malignant bowel obstruction involves deficiency of vital qi and obstruction of intestinal qi,with yang deficiency as the underlying cause.Cold coagulation,qi stagnation,and blood stasis in the intestines are the key pathological factors.Hence,“warming and promoting circulation of three junctions method”is proposed,which integrates the approaches of“warming”,“dissolving”,and“purging”.This method focuses on warming yang to disperse accumulation and regulating qi to eliminate abdominal mass.External treatment modalities such as acupoint application,herbal hot compress,and herbal enema are employed,demonstrating significant clinical efficacy.The approach of warming and promoting circulation of three junctions method in the external treatment of malignant bowel obstruction is reported as follows.

关 键 词：恶性肠梗阻 温通三结法 中医外治 温阳散积 理气消癥 

分 类 号：R273[医药卫生—中西医结合] R730.52[医药卫生—中医肿瘤科] R730.6[医药卫生—中医学]