基于腑以通为用理论讨论脓毒症胃肠功能障碍的中医药治疗进展

Recent Advances in TCM Therapy for Sepsis-Associated Gastrointestinal Dysfunction Guided by the “Fu Yi Tong Wei Yong” Principle

摘要: 胃肠功能障碍(Gastrointestinal Dysfunction, GID)是脓毒症患者常见的并发症，也是影响患者预后的关键因素。《黄帝内经》中提出了“腑以通为用”理论，强调六腑以传导通畅为基本功能，病机核心在于不通，该理论指导下的通腑治法与脓毒症GID的热结腑实、腑气不通病机契合。本文旨在系统综述腑以通为用理论指导下，中医药治疗脓毒症胃肠功能障碍的现代临床研究进展，归纳常用治法与方药、穴位规律，对未来临床研究方向提出展望。

Abstract: Gastrointestinal Dysfunction (GID) is a common complication in patients with sepsis and a crucial determinant of prognosis. The theory of “Fu Yi Tong Wei Yong”, originating from the Huangdi Neijing, posits that the fundamental function of the Fu-organs is to maintain unimpeded flow, with obstruction being the core of their pathogenesis. The “Tong-Fu” therapeutic method, guided by this principle, aligns well with the pathogenesis of sepsis-induced GID, which is characterized by heat accumulation with stool impaction and obstruction of Fu-organ Qi. This paper aims to systematically review the recent clinical research progress of Traditional Chinese Medicine (TCM) in managing sepsis-induced GID, summarize the commonly used therapeutic strategies, herbal formulas, and acupoint application patterns, and provide an outlook on future research directions.