基于“脾常不足”辨治小儿功能性腹痛

Syndrome Differentiation and Treatment of Functional Abdominal Pain in Childhood and Adolescence Based on “Frequent Deficiency of Spleen”

摘要: 功能性腹痛是儿童时期常见的慢性疾病。该病发病机制复杂，病程长，易反复，因其实验室检查多无阳性发现故容易被家长忽视，目前缺乏系统有效的西医治疗方法。本文基于小儿脾常不足的生理病理特点及功能性腹痛的典型临床表现，梳理本病的病因病机，认为食积、寒凝、气郁、痰湿是本病的主要病理因素，四者既能单独致病又常常相兼为患；治疗时应辨清虚实、寒热、兼夹，以调畅气机为基本原则，补运兼施，攻不伤正，时刻顾护小儿脾胃；在治疗之余叮嘱家长培养小儿的饮食习惯、关注其身心健康，防治并重，以减少本病的发生。

Abstract: Functional abdominal pain is a common chronic disease in childhood and adolescence, with complex pathogenesis, long course and relapsing symptoms, which is easily ignored by parents because of the absence of positive results in laboratory examination. Until now, there is still no systematic and effective therapy for this disease. Based on the pathophysiologic characteristics of “frequent deficiency of spleen” and the typical clinical manifestations of function abdominal pain, the article aims at summarizing the etiology and pathogenesis of the disease, considering that indigestion, congealing cold, qi stagnation and phlegm-damp are the main pathogenic factors which can cause disease independently or synergistically. Doctors should distinguish deficiency and excess, cold and hot, while estimating if there are accompanying symptoms. Regulating qi-activity is the basic therapeutic principle of this disease. Promoting the circulation of qi while tonifying and eliminating with no damage to healthy qi are two aspects that need particular attention during treatment. Moreover, assisting parents to cultivate children’s eating habits and pay attention to their physical and mental health also plays a significant role in the prevention and treatment of this disease.