2026 年第 9 期 第 21 卷

基于“微生态-肠-脑轴”理论探析中医药防治术后炎性肠梗阻的研究进展

Research progress of traditional Chinese medicine in preventing and treating postoperative inflammatory small bowel obstruction analysis based on the "microecology-gut-brain axis" theory

作者：秦欢欢1刘世超2刘文涛2周泽2魏志力2郭松林2查育锋2

英文作者：Qin Huanhuan1 Liu Shichao2 Liu Wentao2 Zhou Ze2 Wei Zhili2 Guo Songlin2 Zha Yufeng2

单位：1陕西中医药大学，咸阳712046；2陕西中医药大学第二附属医院普外肝胆科，咸阳712000

英文单位：1Shaanxi University of Chinese Medicine Xianyang 712046 China; 2Department of General and Hepatobiliary Surgery The Second Affiliated Hospital of Shaanxi University of Chinese Medicine Xianyang 712000 China

关键词：微生态-肠-脑轴；中医药；术后炎性肠梗阻；肠结

英文关键词：Microecology-gut-brainaxis;TraditionalChinesemedicine;Postoperativeinflammatorysmallbowelobstruction;Intestinalobstruction

• 摘要：

• 术后早期炎性肠梗阻（EPISBO）是腹部手术后常见并发症，是由多种诱发因素及发病机制造成的动力性和机械性同时存在的肠梗阻。临床症状为腹痛、腹胀、肛门停止排气、排便等，将其归于中医范畴中的“肠结”“关格”。研究发现肠道菌群失调、肠-脑轴应激与EPISBO发生具有相关性，现代临床治疗手段多样，但效果欠佳。而中医药在治疗EPISBO方面具有独特优势，通过调节肠道微生态、下丘脑-垂体-肾上腺轴等促进胃肠蠕动、恢复肠道功能，还可进行辨证论治、个体化治疗来减少炎症反应、缓解临床症状、恢复胃肠道功能。治疗时从病因病机入手，依据其辨证、症状或需求给予中药口服、针刺等手段，以期为相关临床研究提供借鉴。

• Early postoperative inflammatory small bowel obstruction (EPISBO) is a common complication after abdominal surgery, which is a mixed obstructive bowel disorder combining dynamic and mechanical obstruction caused by multiple predisposing factors and pathogenesis. Its main clinical manifestations include abdominal pain, abdominal distension, cessation of anal exhaust and defecation, which are categorized as "intestinal obstruction" and "blockage and rejection" in traditional Chinese medicine. Studies have found that intestinal flora imbalance and gut-brain axis stress are correlated with the occurrence of EPISBO. Although modern clinical treatment methods are diverse, the overall efficacy is unsatisfactory. Traditional Chinese medicine has unique advantages in the treatment of EPISBO. It can promote gastrointestinal peristalsis and restore intestinal function by regulating intestinal microecology and the hypothalamic-pituitary-adrenal axis. Meanwhile, it can reduce inflammatory responses, relieve clinical symptoms and recover gastrointestinal function through syndrome differentiation and individualized treatment. Targeting the etiology and pathogenesis, oral Chinese herbal medicine, acupuncture and other interventions are applied according to syndrome differentiation, clinical symptoms and individual needs, so as to provide references for relevant clinical research.