基于“少阳为生气之首”探讨胆囊切除术后慢性消化病病机

Pathogenesis of Chronic Digestive Diseases after Cholecystectomy Based on the Theory of“Shaoyang is the first source of vitality”

胆囊切除术后不少患者会出现消化系统并发症和后遗症,包括胆囊切除后综合征、慢性胃炎、复发性结石、消化系统肿瘤等,目前这类疾病的中医病机研究尚未完善。本文将通过收集梳理关于少阳胆腑中医生理病理的古籍文献资料,从胆腑统领气化和胆腑为真精化气之枢两个主要方面,全面阐述清代医家沈金鳌“少阳为生气之首”理论源流。在此基础上,与既往相关中西医病机学研究成果相联系,结合六经辨证,对相关疾病逐一进行病机综合探讨,对这些疾病的病机进行细致区分并建立起它们之间的层级联系,更为系统深刻地阐明胆囊切除术后少阳生气作用的失常可能在阳明、少阴、厥阴等多个层面引起脏腑功能失衡,最终导致相应的慢性消化系统疾病。

Many patients after cholecystectomy may experience digestive system complications and sequelae,such as postcholecystectomy syndrome,chronic gastritis,recurrent stones,digestive system tumors,etc.Currently,the research on the pathogenesis of these diseases in traditional Chinese medicine is not yet complete.This article will comprehensively elaborate on the origin and development of the Qing Dynasty physician Shen Jin'ao's theory that“Shaoyang is the first source of vitality”by collecting and sorting out ancient literature on the physiological and pathological features of Shaoyang and the gallbladder in traditional Chinese medicine.Based on this,and in conjunction with previous research achievements in the pathogenesis of traditional Chinese and Western medicine,combined with the differentiation of the six meridians,this article will comprehensively explore the pathogenesis of related diseases.By carefully identifying the pathogenesis of these diseases and establishing hierarchical relationships between them,we can more systematically and profoundly elucidate that the dysfunction of Shaoyang qi after cholecystectomy may cause organ dysfunction at multiple levels,such as Yangming,Shaoyin,and Jueyin,ultimately leading to corresponding chronic digestive system diseases.