中医外治法促进腹部疾病术后胃肠功能恢复的研究进展

Research Progress on the Promotion of Gastrointestinal Function Recovery after Abdominal Surgery by Traditional Chinese Medicine External Therapies

摘要: 腹部疾病术后胃肠功能障碍(POGD)是继发于手术后的一种胃肠道急性病理生理改变，以胃肠道黏膜损害、屏障功能破坏以及胃肠道运动障碍为主要特征。术后大多数患者出现腹胀腹痛、恶心呕吐、排气排便时间延长等症状，POGD患者住院时间更长，住院费用增加，常出现肠梗阻、感染、电解质紊乱等并发症，例如，严重者可导致消化道瘘、严重感染、多器官功能障碍综合征甚至死亡等并发症。深入研究POGD的发病机制并积极寻找有效治疗方法对患者术后恢复具有深刻的意义。POGD一般分为3个阶段，即外科损伤阶段、炎症反应阶段和修复阶段。发病机制尚未完全明确，西医治疗手段单一，临床效果欠佳。而传统的中医外治法治疗术后胃肠动力障碍疾病有独特优势，中医外治法中的针灸、中药灌肠、艾灸、耳穴疗法等为术后POGD的治疗提供了新的治疗手段。文章就腹部疾病术后胃肠功能障碍的病因、发病机制以及中医外治法促进腹部疾病术后胃肠功能恢复的相关研究成果进行综述。

Abstract: Postoperative gastrointestinal dysfunction (POGD) in abdominal diseases is an acute pathophysiological change in the gastrointestinal tract secondary to surgery, characterized by gastrointestinal mucosal damage, barrier function disruption, and gastrointestinal motility disorders. After surgery, most patients experience symptoms such as abdominal distension, abdominal pain, nausea and vomiting, prolonged gas and bowel movements, and prolonged hospitalization. POGD patients have longer hospital stays and increased hospital costs, and often experience complications such as intestinal obstruction, infection, electrolyte imbalance, and other complications. For example, severe cases can lead to complications such as digestive tract fistula, severe infection, multiple organ dysfunction syndrome, and even death. In-depth study of the pathogenesis of POGD and active search for effective treatment methods have profound significance for patients’ postoperative recovery. POGD is generally divided into three stages: surgical injury stage, inflammatory response stage, and repair stage. The pathogenesis is not fully understood, and the treatment methods of Western medicine are single, with poor clinical effects. External treatment methods of traditional Chinese medicine have unique advantages in treating postoperative gastrointestinal motility disorders. Acupuncture and moxibustion, traditional Chinese medicine enema, moxibustion, auricular therapy, and other external treatment methods of TCM provide new treatment options for the treatment of postoperative POGD. This article reviews the causes and pathogenesis of gastrointestinal dysfunction after abdominal surgery, as well as the relevant research results of external treatment methods of traditional Chinese medicine to promote the recovery of gastrointestinal function after abdominal surgery.