新生儿结肠冗长症的中医药辨证治疗

Differentiating and Treating Dolichocolon in Newborns with Traditional Chinese Medicine

新生儿结肠冗长症是结肠发育异常而导致的结肠段及其弯曲部分冗长的先天性消化道畸形,以便秘、腹胀和腹痛为主要临床表现。本病属于中医学“便秘”范畴,文章基于西医的发病机制及新生儿的生理病理特点,探析了中医病因病机、辨证论治和临床验效,认为气津亏虚致大肠传导失司是病机关键,提出益气健脾、润肠通便为本病的基本治则,临床辨证分型为脾虚气滞证、肺脾气虚证、脾虚津亏证、肠道湿热证,分别采用理气导滞、补肺健脾、运脾生津、清热利湿等治法,并结合典型病案展示本病的诊断及辨证论治、具体用药思路及加减用药原则,以期对新生儿结肠冗长症的中医药辨治和临床研究有所裨益。

Dolichocolon in newborns is a congenital malformation of digestive tract caused by abnormal colon development,where redundancies may be located in the part of the colon and at the flexures.The dominating symptoms of dolichocolon are constipation,abdominal bloating and pain.This disease belongs to the category of constipation in Traditional Chinese Medicine(TCM).Based on the pathogenesis of Western medicine and the physiological and pathological characteristics of newborns,this paper explores the etiology,pathogenesis,treatment based on syndrome differentiation and clinical efficacy of TCM.It is considered that the key to pathogenesis is the dysfunctional conduction of large intestine,and there is caused by deficiency of Qi and fluid.It is proposed that invigorating Qi and strengthening spleen,moisturizing and laxative are the basic treatment principles of this disease.Its clinical syndrome differentiation mainly includes spleen deficiency and qi stagnation,lung and spleen Qi deficiency,spleen deficiency and fluid deficiency,and intestinal damp-heat.The treatment methods include regulating Qi to guide stagnation,tonifying lung and spleen,activating spleen and promoting fluid production,clearing away heat and promoting diuresis,etc.Combined with typical diseasecases,it shows the diagnosis,syndrome differentiation,specific medication ideas and treatment and addition and subtraction principles.This article is expected to be beneficial to the TCM differential treatment and clinical research of neonatal dolichocolon.