外科术后气虚血瘀型患者的治疗研究进展

Research Progress in Treatment of Patients with Qi‑Deficiency and Blood‑Stasis Syndrome after Surgical Operation

摘要: 气虚血瘀证是中医常见证候，是一种元气不足与血液运行不畅并存的状态。本质是气虚推动无力，导致血行迟滞成瘀，多表现为气虚症状，如乏力疲倦、气短懒言、自汗、面色苍白或萎黄、食欲不振，以及血瘀的症状，如疼痛固定、局部青紫肿胀、舌质紫暗或有瘀点、脉涩或细弱气虚，另外还有血瘀夹杂症状，如伤口愈合缓慢、四肢麻木或冷感、头晕心悸、便秘或便溏等，影响患者康复进程和愈后。本文综述发现，患者在外科手术后，尤其是骨科、普外科、胸外科等科室，常因手术操作、个体差异、麻醉方式以及术后管理等，在术后出现与气虚血瘀证相关的症状，在临床上常采用药物或非药物等手段进行治疗来改善气虚血瘀的症状。本文撰写的目的是为了系统梳理术后气虚血瘀型患者的治疗方案及研究进展，为临床优化治疗策略提供参考。

Abstract: Qi‑deficiency and blood‑stasis syndrome is a common traditional Chinese medicine (TCM) syndrome characterized by simultaneous deficiency of primordial qi and impaired blood circulation. Its essence lies in insufficient qi failing to propel blood flow, which results in sluggish blood circulation and subsequent blood stasis. Clinical manifestations include qi‑deficiency symptoms such as lassitude, shortness of breath with disinclination to speak, spontaneous sweating, pale or sallow complexion and poor appetite; blood‑stasis symptoms including fixed‑position pain, local cyanosis and swelling, dark‑purple tongue with ecchymoses, thready‑uneven or thready‑weak pulse. Concurrent mixed symptoms include delayed wound healing, numbness or cold sensation of limbs, dizziness and palpitations, constipation or loose stools, which adversely affect patients’ rehabilitation process and prognosis. This review demonstrates that patients after surgical procedures, especially those in orthopedics, general surgery and thoracic surgery departments, frequently develop symptoms relevant to qi‑deficiency and blood‑stasis syndrome owing to surgical trauma, individual differences, anesthetic modalities and postoperative management. Pharmacological and non‑pharmacological interventions are clinically adopted to relieve such symptoms. This paper aims to systematically sort out therapeutic regimens and research progress for postoperative patients with qi‑deficiency and blood‑stasis syndrome, so as to provide references for optimizing clinical treatment strategies.