基于“一气周流”理论论治儿童功能性便秘

Treatment of Functional Constipation in Children Based on the Theory of “One-Qi Circulation”

摘要: 儿童功能性便秘是小儿时期最常见的胃肠道疾病，为儿童便秘的主要原因，也是儿科临床中常见病，多发病，患病率在0.7%~29.6%之间。西医治疗方案本病包括基础治疗、药物治疗等方法，短期症状可有改变，然长期疗效并不理想。中医学认为该病的发生与肺、脾、肝、肾相关，脏腑功能失常，使大肠传导失司而发病。中医以整体观念、辨证论治为指导，结合小儿的生理病理特点，采取个体化、精准化的治疗方案，在临床有着独特的优势。该病也是中医药治疗儿科疾病的优势病种之一。“一气周流”理论是黄元御学术思想的瑰宝，强调中气斡旋在疾病发生发展中的重要性。本文以黄元御“一气周流”理论为指导，结合小儿特点，探讨该病的病因病机、辨证论治，探析强调脾胃中气在儿童功能性便秘的发病、治疗中的重要性。治疗上注重斡旋中气，以恢复脾升胃降为要，以中气为核心兼采用宣降肺金，调畅肝木等治法，终使中气旺盛，一气周流。

Abstract: Functional constipation in children is the most common gastrointestinal disease in pediatrics, which is the main cause of constipation in children, and it is also a common and frequent disease in pediatrics, with a prevalence rate between 0.7% and 29.6%. Western medicine treatment program for this disease includes basic treatment, drug therapy and other methods. Short-term symptoms can be changed, but the long-term efficacy is not ideal. Chinese medicine believes that the disease is related to the lung, spleen, liver and kidney, and that the malfunction of the internal organs causes the disease to develop due to the failure of conduction in the large intestine. Chinese medicine is guided by the holistic concept and evidence-based treatment, combined with the physiological and pathological characteristics of children, and adopts individualized and precise treatment plans, which has unique advantages in the clinic. This disease is also one of the advantages of TCM in treating pediatric diseases. The theory of “one-qi circulation” is a treasure of Huang Yuanyu’s academic thought, which emphasizes the importance of the central qi in the development of diseases. In this paper, we take Huang Yuanyu’s theory of “one-qi circulation” as a guideline, discuss the etiology and pathogenesis of the disease in combination with the characteristics of pediatrics, and analyze the importance of emphasizing the central qi of the spleen and stomach in the pathogenesis and treatment of functional constipation in children. The treatment focuses on mediating the central qi, restoring the spleen to rise and the stomach to fall as the main point, and at the same time adopting the treatment method of declaring and lowering the lung gold and regulating the liver and wood, so as to make the central qi vigorous and the one-qi circulation.