湿秘之中医刍议及相关影响因素现代研究进展

Discussion on Damp Constipation in Traditional Chinese Medicine and Modern Research Progress on Related Influence Factors

便秘是以排便周期延长、排便不畅或艰难为主要表现的病证,总分虚实两端。湿秘作为便秘的一种特殊分类,主要表现为便质不干或黏滞,排便不爽,兼夹全身气机不畅、缠绵难愈的特点。古代医籍对于湿秘有诸多记载,现代中医学者之经验论述也颇多。湿秘之病因当分为内湿与外湿,病机以脾胃虚弱为本,湿阻气滞为标,致大肠传导失司,糟粕内停,临床辨证论治遵循健脾、理气、祛湿三大原则,湿邪日久或酿生湿热或阻遏阳气,临证兼以清热或温润之法。目前湿邪之研究分布在各个领域,与便秘之共作用因素主要集中于肠道菌群、胃肠动力、糖脂代谢及幽门螺杆菌感染4个方面,且各因素之间互为影响。但目前现代医学针对于湿秘之病理机制的系统论述及基础研究仍较欠缺,本研究从中医病名溯源、病因病机、辨证论治及现代医学相关影响因素几方面阐述湿秘,为后续更进一步的临床研究及诊治提供一定借鉴意义。

Constipation is a disease characterized by prolonged defecation cycle,poor or difficult defecation.Damp constipation,as a special classification of constipation,is mainly manifested as the stool is not dry or sticky,the feeling of defecation is unpleasant,combined with the stagnant of Qi in the body,which is lingering and difficult to heal.There are many records about damp constipation in ancient medical books,and modern Chinese medicine scholars also have a lot of experience and discussion on this disease.The etiology of damp constipation can be divided into internal dampness and external dampness,and the pathogenesis is based on weakness of the spleen and stomach,marked by dampness blocking Qi,which lead to the failure of the conduction of the large intestine,and dregs stopping inside.The principles of clinical treatment are invigorating spleen,regulating Qi and dispelling dampness.Because dampness over a long period of time may generate dampness-heat or block yang Qi,clinical treatment should be clearing heat or Wenrun therapy.At present,the research of pathogenic dampness is distributed in various fields,and the co-acting factors of constipation mainly focus on four aspects:gut microbes,gastrointestinal motility,glycolipid metabolism,and HP infection,and the factors are influenced by each other.However,there is still a lack of systematic discussion and basic research on the pathogenesis of damp constipation in modern medicine.This study elaborates on damp constipation from the traceability of Chinese medicine name,etiology and pathogenesis,syndrome differentiation and treatment and the relevant influencing factors on modern medicine,which can provides certain reference for the subsequent further clinical research and treatment of damp constipation.