形气神理论指导下脏腑推拿治疗肝郁气滞型 功能性腹胀的理法探讨

Discussion on the Principles and Methods of Visceral Manipulation in the Treatment of Functional Bloating (Liver Qi Stagnation Pattern) Guided by the Theory of Form, Qi, and Spirit

摘要: 功能性腹胀是以腹部胀满感或腹部膨隆为主要表现的常见胃肠道功能性疾病，其中肝郁气滞型最为多见。本文系统梳理中医形气神理论的内涵及其在肝郁气滞型功能性腹胀病机阐释中的应用，提出本病以“形损为基、气滞为机、神乱为因”的三维病机结构。在此基础上，深入探讨脏腑推拿通过“调形以疏肝、理气以和胃、安神以解郁”三个层次干预病机的治疗机制。形气神理论为肝郁气滞型功能性腹胀的推拿治疗提供了整体性的理论框架，脏腑推拿通过手法作用于形体、气机与神志三个维度，契合本病形气神失调的病机本质，具有明确的临床价值与理论意义。

Abstract: Functional bloating (FB) is a common functional gastrointestinal disorder primarily characterized by a sensation of abdominal fullness or visible distention, with the Liver Qi Stagnation pattern being the most prevalent clinical manifestation. This paper systematically reviews the connotations of the TCM Theory of Form, Qi, and Spirit and its application in explaining the pathogenesis of FB (Liver Qi Stagnation type). We propose a three-dimensional pathogenic structure for this condition: “impairment of Form as the foundation, stagnation of Qi as the mechanism, and disturbance of Spirit as the cause”. Building upon this framework, we conduct an in-depth exploration of the therapeutic mechanisms of Visceral Manipulation (Zang-Fu Tuina) across three intervention levels: “adjusting Form to soothe the Liver, regulating Qi to harmonize the Stomach, and calming the Spirit to relieve depression”. The Theory of Form, Qi, and Spirit provides a holistic theoretical framework for the massage treatment of FB. By applying manual techniques to the dimensions of physical form, Qi dynamics, and mental state, Visceral Manipulation aligns with the pathogenic essence of “Form-Qi-Spirit” disharmony, demonstrating significant clinical value and theoretical importance.