广州中医药大学学报2026，Vol.43Issue(1)：262-267,6.DOI:10.13359/j.cnki.gzxbtcm.2026.01.036
调中复衡以防治脓毒症胃肠损伤的思路探讨
Exploring the Approach of Regulating Middle-Jiao and Restoring Balance to Prevent and Treat Sepsis-Induced Gastrointestinal Injury
摘要
Abstract
As one of the most common complications of sepsis,sepsis-induced gastrointestinal injury is not only a key initiating factor for multiple organ dysfunction syndrome(MODS)but also a critical determinant of patient prognosis.The intestinal barrier disruption,gut microbiota dysbiosis,and metabolic and immune imbalances observed in sepsis-induced gastrointestinal injury exacerbate multiple organ failure.This article proposes that the core traditional Chinese medicine(TCM)pathogenesis of sepsis-induced gastrointestinal injury is due to the disharmony of middle-jiao,which is characterized by spleen deficiency as the root cause and fu-organ excess as the manifestations.The pathogenesis shares similarities with the ecological imbalance of the gut microbiota during sepsis,explaining how dysfunction in the spleen's ascending and the stomach's descending disrupts the intestinal microecological environment.This disruption initiates a vicious cycle of imbalanced microbiota structure and abnormal metabolic products,ultimately leading to intestinal epithelial injury and a systemic inflammatory storm.The prevention and treatment of sepsis-induced gastrointestinal injury can be conducted by the approach of regulating middle-jiao and restoring balance,which combines unblocking and descending methods with spleen-fortifying method to restore intestinal motility,gut microbiota,and immune homeostasis.In clinical practice,this can be achieved through the combined use of representative formulas such as Lizhong Decoction and Chengqi Decoction.This approach not only improves the microbiota's nutritional microenvironment by regulating middle-jiao but also clears toxic metabolites produced by the dysbiotic microbiota,and then delays the progression of sepsis-induced gastrointestinal injury through the method of restoring balance.The approach of regulating middle-jiao and restoring balance highlights the unique advantage of the TCM holistic concept in regulating the metabolism-immunity interaction,potentially providing insights for the clinical management of sepsis-induced gastrointestinal injury.关键词
脓毒症/胃肠损伤/肠道菌群/代谢/免疫/中焦失和/调中复衡/通降/健脾/理中汤/承气汤Key words
sepsis/gastrointestinal injury/gut microbiota/metabolism/immunity/disharmony of middle-jiao/regulating middle-jiao and restoring balance/unblocking and descending/fortifying the spleen/Lizhong Decoction/Chengqi Decoction分类
医药卫生引用本文复制引用
肖其梅,袁康,赵雅雯,王亚萌,朱天威,梁章荣..调中复衡以防治脓毒症胃肠损伤的思路探讨[J].广州中医药大学学报,2026,43(1):262-267,6.基金项目
国家自然科学基金项目(编号:82374216) （编号:82374216）
广东省中医药局课题(编号:20251364) （编号:20251364）
