刘访 曹波 李志 董聿锟 卢丹

摘要 慢性功能性便秘是临床常见病及难治性疾病，目前尚缺乏有效统一的治疗方案。现从中医“肺与大肠相表里”理论出發，分析便秘的病因病机与肠、肺之间的关系，归纳总结中医药在便秘方面的研究，结合“肠病治肺，肠肺同治”的便秘治法理念，探析“通腑理肺法”治疗便秘的理论依据，并且列举案例1则，为慢性功能性便秘提供新的临床治疗思路。

关键词 肺与大肠相表里;通腑理肺法;慢性功能性便秘;阴虚肠燥;肠病治肺;肺肠同治;腑病治脏;脏腑同治

Abstract Chronic functional constipation is a common and refractory disease.At present，there is still no effective unified treatment plan.This paper starts from the theory of“interior and exterior relationship between the lung and large intestine”to analyze the relationship between the etiology and pathogenesis of constipation and the intestines and lungs.The research of Chinese medicine on constipation is summarized，combined with the concept of “treatment of intestinal disease by lung” and “intestinal and pulmonary diseases being treated simultaneously”.The “catharsis and regulating qi method” for the treatment of constipation is explored.Case 1 is enumerated to provide new clinical treatment ideas for chronic functional constipation.

Keywords Interior and exterior relationship between the lung and large intestine; Catharsis and regulating qi method; Chronic functional constipation; Yin deficiency intestinal dryness; Treatment of intestinal disease by lung; Simultaneous treatment of lung and intestine; Treatment of Fu disease by Zang; Simultaneous treatment of Zangfu viscera

中图分类号：R242文献标识码：Adoi：10.3969/j.issn.1673-7202.2020.17.032

慢性功能性便秘（Chronic Functional Constipation，CFC）是临床上最常见病、多发病之一。便秘对25%以上的患者来说，它不仅是一种无关紧要的不适，而是严重会影响到生命质量的疾病[1-3]。相关研究结果显示，在我国老年人便秘的发生率高达18.1%，明显高于一般人群[4]。便秘对人体的危害越来越明显，不仅仅指其症状本身对人体的影响，而便秘诱发的很多疾病（如急性心、脑血管疾病等）可直接增加患者的死亡率[5]。近年来，随着人们饮食结构的改变及人口老年化，便秘的发病率不断上升，已经成为研究的热点及难点，并引起了广泛医学研究者们的关注。

1 对便秘的认识

据相关文献[6-7]研究，便秘根据其病理生理机制可划分为：慢传输型便秘（Slow Transit Constipation，STC）、排便障碍型便秘（Defecatory Disorder）、混合型便秘、正常传输型便秘（Normal Transit Constipation，NTC）。临床上以慢传输型便秘（STC）最为常见，STC是由于结肠的传输功能减弱或受损而导致的肠道内容物传输缓慢或传输困难而出现的临床症状。……