左世国，郑学均，石林，向昱阳

〔摘要〕 腹胀、便秘是胸腰椎骨折后及术后最常见的并发症，本文通过对近五年中药治疗胸腰椎骨折后及术后腹胀、便秘的临床研究文献进行检索整理分析，发现目前中药治疗本病的研究可分为中药内服、外治及内外合治3个方面，内治处方以泻下通便、行气导滞、润肠通便、攻下逐瘀为主要治法，外治及内外合治则在其基础上加用外治法增强疗效。

〔关键词〕 中医药;胸腰椎骨折;骨折后;术后;腹胀;便秘

〔中图分类号〕R256       〔文献标志码〕A        〔文章编号〕doi：10.3969/j.issn.1674-070X.2021.11.030

Research Progress of Abdominal Distension and Constipation after Thoracolumbar Fracture and Postoperative Treatment with Traditional Chinese Medicine in Recent Five Years

ZUO Shiguo1， ZHENG Xuejun2*， SHI Lin2， XIANG Yuyang2

（1. Hunan University of Chinese Medicine， Changsha， Hunan 410208， China;

2. Traditional Chinese Medicine Hospital Dianjiang Chongqing， Chongqing 408300， China）

〔Abstract〕 Abdominal distension and constipation are the most common complications after thoracolumbar fracture and postoperative. In this paper， the literature of clinical research on abdominal distension and constipation after the treatment of thoracolumbar fracture and postoperative with traditional Chinese medicine （TCM） in the past five years were searched and analyzed. It is found that the research on TCM treatment of this disease can be divided into three aspects： internal treatment， external treatment and internal and external treatment. The internal treatment prescriptions mainly include purging and defecating the bowels， inducing Qi stagnation， nourishing bowel and removing blood stasis， while external treatment and internal and external treatment are added to enhance the curative effect.

〔Keywords〕 traditional Chinese medicine; thoracolumbar fracture; after fracture; postoperative; abdominal distension; constipation

胸腰椎骨折是骨科臨床常见的疾病，是老年人常见的骨折[1]，腹胀、便秘是胸腰椎骨折及术后常见的并发症，主要表现为腹胀、腹痛、排便困难等。本病的病因及发病机制尚不完全明确，主要认为骨折后血肿形成可对周围交感神经产生压迫及损伤，加之麻醉药物、止痛药物、焦虑抑郁及排便习惯改变对交感神经的抑制作用，导致胃肠道蠕动功能减退，甚至停止，引起腹胀、便秘的发生[2]。据资料统计，胸腰椎骨折术后第1天腹胀的发生率高达69.1%，住院期间患者腹胀的发生率高达83.3%[3]。如果不及时处理，可导致多种并发症，研究[4-5]表明，严重腹胀会引起腹压升高、下腔静脉回流受阻而出现下腔静脉栓塞，还会加重高血压、冠心病患者病情。因此，及时有效处理本病显得尤为重要，现就近五年中药治疗胸腰椎骨折后及术后腹胀、便秘的研究进展进行综述如下。

1 中药内治法

1.1  行气导滞法

中医学认……