摘要
Abstract
Epigastric pain syndrome(EPS)is a subtype of functional dyspepsia,characterized by visceral hypersensitivity as its core pathological feature,with its mechanism yet to be fully elucidated.Based on the traditional Chinese medicine(TCM)theory of"Qi(气)deficiency stagnation"and integrating modern medical research,this article systematically explores the pathogenic essence of visceral hypersensitivity in EPS and its associated mechanisms in both TCM and Western medicine.The study posits that the core pathogenesis of EPS is"deficiency in essence and stagnation in manifestation",with spleen Qi deficiency as the root of"deficiency of vital Qi",whereas Qi stagnation,phlegm coagulation,and blood stasis as the manifestations of"stagnation".Deficiency and stagnation are not isolated but interdependent,forming a vicious cycle of"deficiency leading to stagnation,and stagnation exacerbating deficiency",which constitutes the core pathogenic basis of the chronicity and intractability of EPS.From the perspective of"Qi deficiency stagnation",the modern biological underpinnings of visceral hypersensitivity can be summarized into three interrelated levels:firstly,dysfunction of Zang-Fu(脏腑)Qi movement(functional level),corresponding to autonomic nervous system dysregulation and gastrointestinal motility disorders,which represents the initial pathogenic link of"deficiency of vital Qi",Secondly,neuro-hormonal axis imbalance,such as vagus nerve pathway abnormalities,central sensitization,and gastrointestinal hormone secretion disorders,serves as a crucial bridge for the transition from"deficiency to stagnation",linking central perception(spirit)with peripheral function(form),and mediating the"pain-anxiety"cycle,thirdly,the mutual accumulation of phlegm and blood stasis,obstructing the collateral channels(tissue pathological changes),leads to abnormal channel function and subsequent sensitization of nerve endings,directly resulting in a decreased visceral sensory threshold(peripheral sensitization)and amplification of pain signals.These factors collectively establish the modern biological foundation of visceral hypersensitivity in EPS.Based on the aforementioned pathogenic understanding,the treatment should focus on invigorating spleen Qi as the fundamental approach,supplemented by methods to promote Qi circulation,resolve phlegm,and eliminate blood stasis,aiming to restore the ascending and descending functions of the spleen and stomach,reduce visceral sensitivity,and achieve gastrointestinal motility balance.This study provides new insights into the integrative medicine diagnosis and treatment of EPS guided by the"Qi deficiency stagnation"theory,highlighting the unique advantages of TCM in harmonizing deficiency and excess,and differentiating and treating epigastric pain.关键词
上腹痛综合征/内脏高敏感/虚气留滞/中西医结合/胃肠动力障碍Key words
Epigastric pain syndrome/Visceral hypersensitivity/Qi deficiency stagnation/Integrated Chinese and Western medicine/Gastrointestinal dysmotility分类
医药卫生
