功能性便秘之中醫治療

The Treatment of Functional Constipation by Traditional Chinese Medicine

林建仲(Chien-Chung Lin) ； 黃千容(Chien-Jung Huang) ； 吳宏乾(Hung-Chien Wu)

《北台灣中醫醫學雜誌》 2卷2期 (2010/12) Pp. 1-14

https://doi.org/10.30127/BTWZYYXZZ.201012.0001

摘要

便秘是臨床常見主訴，便秘是指腸道排便緊張，或者腸道排便每週少於三次。西醫現代研究可將便秘分為功能性或器質性病變所致。本篇中醫內容以功能性便秘為討論範疇，整理出便秘的主要證型可分為實證便秘之鬱熱便秘、氣滯便秘，及虛證便秘之氣虛便秘、血虛便秘、陰虛便秘、陽虛便秘。藥物治療方面，鬱熱便秘常用麻子仁丸；氣滯便秘常用六磨湯；氣虛便秘常用黃耆湯或補中益氣湯；血虛便秘常用潤腸丸；陰虛便秘常用益胃湯或增益湯合六味地黃丸；陽虛便秘常用濟川煎。另外列出常用適合之單味中藥可供加味。便秘的針灸治療，有不分證型皆可使用之通用穴組，其中以天樞、大腸俞、支溝使用頻率較高，在各證型中此三穴也扮演著主穴的地位，再予以適當的配穴，取得療效。除了藥物與針灸治療外，衛教病人在日常生活中可自行運用耳壓、按摩、食療、藥膳等治療方法，以增進排便的改善效率。

關鍵字

便秘 ； 中藥 ； 針灸 ； 按摩 ； 食療針刺

並列摘要

Constipation is a common clinical chief complaint. It is defined as emotional nervousness during stool discharge or fewer stool discharge frequency less than three times in a week. In western modern medicine, the etiology of constipation are divided into two categories: functional or organic constipation. Our article discussed the category of functional constipation. The muggy constipation and stagnated constipation of Qi are caused by excess syndrome of constipation, and constipation due to Qi vacuity, blood vacuity, Yin vacuity and Yang vacuity are categorized into aesthetic syndrome, In therapeutically aspect: muggy constipation, ma-zhi-ren wan (hemp seed pill); stagnated constipation of Qi, liu-mo decoction (six herbal laxative decoction); constipation of Qi vacuity, astragalus albiflora decoction or bu-zhong-yi-qi decoction (decoction for invigorating the spleen and replenishing Qi); constipation of blood vacuity, ren-chang decoction (decoction for smoothing intestine); constipation of Yin vacuity, yi-wei decoction (decoction for reinforcing stomach) or zheng-yi decoction (decoction for enhancing vitality) mixed with liu-wei-di-huang pill (six herbs combinational pill including Rehmannia glutinosa); constipation of Yang vacuity, ji-chuang decocta. Besides, we list commonly used singular herb for additional formula modification. In the therapeutically aspect of acupuncture to constipation, we found the commonly used acupoint group for each symptoms, within these acupoints, the Tianshu (ST25), Dachangshu (BL25), Zhigou (SJ6) are more frequently used in clinical practice. The above three acupoints are acted as the major role in acupuncture therapy for each subtypes of syndrome in constipation. Better therapeutic effects can be acquired with additional appropriate coordinated acupoints applied. Except therapy of Chinese herbal medicine and acupuncture, hygiene education including auricle message, body message, diet therapy and Chinese medicinal cuisine or other therapeutic method in daily life can be taught to patients to increase the efficiency of stool discharging.

並列關鍵字

Constipation ； Chinese Medicine ； Acupuncture ； Message ； Dietary Therapy