基于“六腑以通为用”探究中医治疗急性胆源性胰腺炎的研究进展

Research Progress on Traditional Chinese Medicine Treatment for Acute Biliary Pancreatitis Based on the Theory of “The Six-Fu-Organs Must Keep Their Unobstructed”

摘要: 急性胆源性胰腺炎(Acute Biliary Pancreatitis, ABP)是临床上常见的急腹症，目前西医常规治疗虽能缓解症状，但在改善长期预后、降低复发率方面仍有局限。文章基于“六腑以通为用”理论，通过梳理分析相关文献，系统综述中医药治疗ABP的研究现状。中医认为，ABP的发病始于胆汁淤积，胆腑失于通降，肠腑传导失司为病情进展的关键一环，而六腑之间相互传变，病势变化迅速，故应从六腑整体论治。临床研究表明，以此理论为指导的中医内治、中医外治、中西医结合治疗法，能有效缓解腹痛腹胀、减轻炎症反应、减少术后并发症、降低复发率等。研究认为，“六腑以通为用”精准概论了ABP的发病核心，为该病的诊疗提供了理论支撑，但不足的是，目前高质量的循证医学证据仍旧不足，需开展多样本、多中心的随机对照试验，使治疗方案标准化、规范化。

Abstract: Acute biliary pancreatitis (ABP) is a common acute abdominal emergency in clinical practice. Although conventional Western medical treatment can alleviate symptoms, it still has limitations in improving long-term prognosis and reducing recurrence rates. Based on the theory of “The six-fu-organs must keep their unobstructed”, this paper systematically reviews the current research status of traditional Chinese medicine (TCM) in the treatment of ABP through literature analysis. According to TCM, the pathogenesis of ABP originates from bile stasis and loss of normal descending function of the gallbladder, while dysfunction of intestinal conduction serves as a critical link in disease progression. Since the six-fu-organs influence each other through mutual transmission and the disease condition changes rapidly, treatment should be approached from a holistic perspective targeting all six-fu-organs. Clinical studies have demonstrated that TCM internal therapy, external therapy, and integrated traditional Chinese and modern medicine guided by this theory can effectively alleviate abdominal pain and distension, reduce inflammatory responses, decrease postoperative complications, and lower recurrence rates. This paper concludes that the theory of “The six-fu-organs must keep their unobstructed” precisely summarizes the core pathogenesis of ABP and provides a theoretical foundation for its diagnosis and treatment. However, a notable deficiency remains that high-quality evidence-based medical data are still insufficient, and future research should prioritize multi-center, large-sample randomized controlled trials to promote the standardization and normalization of treatment protocols.