Zhi-Qiang Chen
Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou (510120), China.
Zhongguo Zhong Xi Yi Jie He Za Zhi. 2013 Feb;33(2):149-54.
By summarizing the literature and clinical experiences, the author analyzed the pathogenesis of gastrointestinal functions and the diagnosis and treatment progress of Chinese medicine and Western medicine. The author addressed the main reason for gastrointestinal dysfunction was enteroparalysis (lack of motive power). Its pathogenesis was mainly due to deficiency syndrome, or to dominant deficiency syndrome with mingled deficiency and excess. According to the principle of treating different diseases by the same method, syndrome typing based strategies for treating postoperative gastrointestinal dysfunction in the perioperative phase should strengthen body resistance and supplement deficiency, or strengthen body resistance and dispel evil pathogens as the main principal method. Although purgations such as Dachengqi Decoction played a role in promoting gastrointestinal motive power, they were not suitable for major patients with selective surgeries induced gastrointestinal dysfunction. They were mainly suitable for acute abdomen patients with heat accumulation in Fu-organs as main symptoms, or for individual patients with interior heat induced excess syndrome.
通过总结文献及临床经验，作者分析了胃肠功能的发病机制以及中西医的诊断与治疗进展。作者指出胃肠功能障碍的主要原因是肠麻痹（动力缺乏）。其发病机制主要为虚证，或以虚为主、虚实夹杂。根据同病异治原则，围手术期术后胃肠功能障碍的辨证论治策略应以扶正补虚，或扶正祛邪为主要治法。虽然大承气汤等泻下剂对促进胃肠动力有作用，但不适用于择期手术所致胃肠功能障碍的大部分患者。它们主要适用于以腑气不通为主症的急腹症患者，或内有实热之实证的个别患者。
