从“阳化气,阴成形”论治肿瘤术后不完全肠梗阻

Diff erentiating and treating incomplete intestinal obstruction after tumor operations based on the theory of"yang transforming qi,while yin shaping up body"

基于肠梗阻病理生理学知识与中医学认识,提出肿瘤术后不完全肠梗阻应重视“阳化气,阴成形”的病机特征,具体而言,“阴成形”过盛是机械性肠梗阻病理基础;“阳化气”不足是动力性肠梗阻病机特征;阳气转枢失司易致虚实夹杂、寒热错杂。治疗应以“扶阳消阴”为大法,以疾病早期-中期-晚期发展3阶段为线索,明辨不同脏腑阳虚偏重,有目的地充养脏腑阳气,并佐以转枢阳气、消阴抑瘤之法,以达到治病求本之效。

An incomplete intestinal obstruction is a common postoperative complication in patients with abdominal or pelvic tumors,which can not only infl uence the quality of life of patients but also be life-threatening.Based on its pathophysiology and the understanding of traditional Chinese medicine,it is proposed that its pathogenesis characteristics of"yang transforming qi,while yin shaping up the body"be highlighted.Specifi cally,the excess of"yin shaping up the body"is the pathological basis of a mechanical intestinal obstruction,while the defi ciency of"yang transforming qi"is the pathogenesis characteristic of a dynamic intestinal obstruction.The failure of yang transforming qi can easily lead to an intermingled defi ciency and excess,as well as an intermingled cold and heat.Therefore,its treatment should be based on the principle of"supporting yang and eliminating the abundance of yin",taking the three stages of its development as a clue to clearly distinguish the yang deficiency in different zang-fu organs and purposefully to nourish the yang qi of the zang-fu organs in order to achieve the effect of assisting yang to eliminate the abundance of yin.