基于“阳化气,阴成形”谈恶性肿瘤术后胃瘫综合征

Postsurgical gastroparesis syndrome after malignant tumor operation based on the principle that “yang transforms into qi,while yin constitutes form”

中医认为,恶性肿瘤术后胃瘫综合征(postsurgical gastroparesis syndrome,PGS)属于“痞满”“呕吐”等范畴,多由脾胃阳虚、气机不利所致,恶性肿瘤、手术及药物治疗、术后足能量营养支持均会诱发或加重PGS。“阳化气,阴成形”出自《素问·阴阳应象大论篇》,意即机体发挥正常的的生理功能依赖于“阳化气”与“阴成形”的相对平衡。因此,若“阳化气”不足,则气血津液升降失常,瘀血、痰浊、寒湿等病理产物积聚于胃肠,即“阴成形”有余,发为PGS。故对于PGS的中西医治疗当以温阳化气治本,辅以祛痰除湿、软坚通便等治标,补虚泻实,祛邪扶正,内外同治,从而提高疗效、改善患者愈后。

According to traditional Chinese medicine,postsurgical gastroparesis syndrome(PGS) after malignant tumor surgery falls under the categories of piman(abdominal lumps and fullness) and outu(vomiting).It is mostly caused by deficiency of spleen and stomach yang and impaired qi movement.Malignant tumors,surgical procedures,drug treatments,and inadequate postoperative nutritional support can induce or exacerbate PGS.The concept that “yang transforms into qi and yin constitutes form” originates from the Huang Di Nei Jing(The Yellow Emperor's Inner Classic).The body's normal physiological function relies on the relative balance between yang transforming into qi and yin constituting form.Insufficient yang qi leads to abnormal ascension and descension of qi,blood,and body fluids,resulting in the accumulation of pathological products like blood stasis,phlegm turbidity,and cold dampness in the gastrointestinal tract—this signifies an excess of yin constituting form,leading to PGS.Therefore,the treatment for PGS should involve warming yang qi to address the root cause,supplemented by measures to remove phlegm,eliminate dampness,soften firmness,relieve constipation,tonify deficiency,drain excess,expel pathogens,and support normal qi.This comprehensive approach aims to improve treatment efficacy and enhance patient recovery.