胃气理论在急性胃肠损伤中运用探析

Guiding Application of Stomach Qi Theory to Acute Gastrointestinal Injury

“人无胃气曰逆,逆者死”,胃气很早就用于评估危重症患者的预后转归。急性胃肠损伤(AGI)指危重症患者的胃肠功能障碍,“有胃气则生”,因而保胃气在AGI治疗中贯穿全程。虚实夹杂引起中焦气机逆乱是AGI的病机特点,早期邪盛为主应祛邪泻实和调畅气机以及时遏制邪损胃气,其中邪实多责之于热、瘀、湿,同时少佐补益脾胃之药以顾护胃气;后期脾胃亏虚为主应补养脾胃增益胃气,鼓动正气祛邪和兼清余邪。“留得一分胃气便留得一份生机”,正确把握祛邪扶正的时机和方向,运用中医药保胃气以期为AGI患者争取生机和改善预后。

"People without stomach qi are passive,which will lead them to death."Stomach qi has long been used to evaluate the prognosis of critically ill patients.Acute gastrointestinal injury(AGI)refers to gastrointestinal dysfunction in critically ill patients."If there is stomach qi,there is life".Therefore,we should keep stomach qi goes through the whole process of AGI treatment.The pathogenesis of AGI is characterized by the combination of deficiency and excess,which leads to the disorder of the central energizer qi mechanism.In the early stage,when the excess of pathogenic factor dominates,we should dispel the pathogenic factors and purge the excess and regu-late the qi mechanism to prevent from damaging stomach qi in a timely manner.The excess of pathogenic factors should be more responsible for heat,blood stasis and dampness,and at the same time,the drugs for invigorating the spleen and stomach should be less used to protect stomach qi.In the later stage,when the deficiency of spleen and stomach dominates,we should nourish the spleen and stomach to gain stomach qi,encourage the healthy qi to dispel the evil and simultaneously clear the residual evil."Keep a share of stomach qi and keep a share of life".We should correctly grasp the opportunity and direction of eliminating pathogenic factors and support the healthy,and use traditional Chinese medicine to protect stomach qi in order to fight for vitality and improve the prognosis for AGI patients.