基于气机升降理论从健脾通腑论治急性胰腺炎  

Treatment of Acute Pancreatitis by Invigorating the Spleen and Dredging the Fu Viscera Based on the Theory of Ascending-descending of Qi Movement

作　　者：闵星 田锋亮[1] 黄学宽[2] 秦百君 罗杨 聂丹 Min Xing;Tian Fengliang;Huang Xuekuan;Qin Baijun;Luo Yang;Nie Dan(Chongqing Traditional Chinese Medicine Hospital,Chongqing 400021,China)

机构地区：[1]重庆市中医院,重庆400021 [2]重庆医科大学,重庆400016

出　　处：《中国中医急症》2025年第3期435-438,446,共5页Journal of Emergency in Traditional Chinese Medicine

基　　金：重庆市中医脾胃病名科建设项目(渝卫2023-00329)。

摘　　要：急性胰腺炎是胰酶激活后引起胰腺渗出、水肿、出血甚至坏死的炎症反应,可继发多器官功能损害的综合征。本研究团队认为,多种原因导致腑气不通、气机升降失常可引起急性胰腺炎发作,气机升降失常可继发津血代谢异常,引起三焦改变出现多脏器功能损伤,而腑气不通、气机升降失常的始动因素与脾胃虚弱有关。故笔者提出,急性胰腺炎以脾胃虚弱为发病基础,气机升降不利为发病枢纽,腑气不通为首要发病环节,三焦气化失司为疾病发展的重要病机,需动态分析其病机演变,治则上以恢复气机升降为主,治法以健脾益气、恢复升降,通腑行气、祛除湿邪,疏利三焦、兼顾变证为主,从而为其提供新的临床治疗思路和方法。Acute pancreatitis is an inflammatory response caused by the activation of pancreatic enzymes,leading to pancreatic exudation,edema,bleeding,and even necrosis,which can subsequently result in multi-organ dysfunction syndrome.Our research team believes that various factors causing impaired fu qi movement and abnormal ascending and descending qi movements can trigger acute pancreatitis.The disruption of qi movement can lead to abnormalities in body fluid and blood metabolism,affecting the Sanjiao system and causing multi-organ dysfunction.The initiating factor for impaired bowel qi movement and disrupted qi circulation is closely related to spleen and stomach weakness.Therefore,we propose that acute pancreatitis is based on spleen and stomach deficiency as its pathological foundation,with impaired qi movement as the key pathogenic mechanism,and obstructed fu qi movement as the primary pathological link.Dysregulation of the Sanjiao′s qi transformation plays a significant role in disease progression.It is necessary to dynamically analyze the evolution of the disease mechanism.In treatment,the focus should be on restoring normal qi movement through methods such as strengthening the spleen and invigorating qi,promoting fu qi movement,removing dampness,regulating Sanjiao,and addressing potential complications.This provides new clinical treatment strategies and approaches for managing acute pancreatitis.

关 键 词：急性胰腺炎 气机升降 健脾通腑 疏利三焦 

分 类 号：R576[医药卫生—消化系统]