中医辨治腹膜炎的新思考

New thoughts of TCM treatment on peritonitis

腹膜炎是外科常见的急腹症,中医治疗腹膜炎多以清热解毒、泄热通腑、行气活血等治法为主,疗效有待提高。笔者认为腹膜炎是三焦的病变,病名应为"三焦约",以毒热、气滞、湿阻、血瘀为主要病理,以三焦气机不畅、气化不利、水谷不通为主要病机。文章对比分析了目前中医治疗腹膜炎临床及实验研究的不同治法,认为开达膜原、分消走泄治法更符合腹膜炎病位的中医治法,为临床治疗腹膜炎提供了新的视角。

Peritonitis is a common acute abdominal disease in surgery.Traditional Chinese medicine(TCM)treatment on peritonitis is mainly based on clearing heat and detoxifying toxins,relieving heat and dredging internal organs,promoting qi and activating blood circulation,but the curative effect needs to be improved.The author considers that peritonitis is the disease of triple energizer,and its name should be’sanjiao restrained’with toxic heat,qi stagnation,dampness obstruction and blood stasis as the main pathological changes,and the main pathogenesis are dysfunction of qi,disadvantage of gasification,and stagnation of dietary.This paper compares and analyses the different therapies of TCM in treating peritonitis in clinical and experimental studies.It is concluded that the treatment of relieving moyuan,separation and dissipation is more in line with the TCM treatment of peritonitis position,which provides a new perspective for clinical treatment of peritonitis.