从浊气理论论治二氧化碳气腹术后应激反应

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[关键词］浊气；二氧化碳气腹；腹腔镜手术；应激反应；疏肝健脾；中医治疗[中图分类号］R256.3；R616.5 ［文献标志码］A [文章编号]0256-7415（2025）20-0157-06DOl：10.13457/j.cnki.jncm.2025.20.029

Treating Postoperative Stress Response After Carbon Dioxide Pneumoperitoneum from Theory of Turbid Qi

SHICensong1，PAN Wen1，XUShenghao1，WUJing1，CHENYuanyan²

1.GuangzhouUniversityofChineseMedicine，GuangzhouGuangdong51o6，China；2.GuangzhouHospitalofIntegratedTaditional and Western Medicine，Guangzhou Guangdong 51O8Oo，China

Abstract：The postoperative stress response following carbon dioxide pneumoperitoneum has become a major factorlimiting rapid recovery in patients undergoing laparoscopic surgery.Its mechanism is complex，involving multiple organs，and there is no unified diagnosis or treatment protocol in traditional Chinese medicine.Theauthors posit that this stressresponseiscloselyrelatedtodysfunctionofthe liverandspleen，with turbidqi-auniquepathologicalproduct of this procedure-servingasakeycausative factor.Thisarticle elucidates the pathogenic processof turbid qiin liverspleen disharmony，focusing on the mechanisms of wood depression failing to disperse and earth stagnation with pathogenaccumulation.It proposes thattheliver，bearing turbid qi，over-restrictingon the spleen，leading to turbid qi retention inthe spleen-earth and generating turbid pathogens.Basedon the principles that "treating wood depression resolvesalldepressions"and "the spleen qi permeates allfive zang-organs"，the therapeutic strategyof soothing the liverand strengthening thespleen is established.Treatment should distinguish primaryor secondary aspectsof liver depression versus spleen-earth stagnation，with flexible modifications according to specific postoperative symptoms to achieve a holistic approach addressing both physical and psychological aspects.

Keywords：Turbid qi；Carbon dioxide pneumoperitoneum；Laparoscopic surgery ；Stressresponse；Soothing liverand strengthening spleen；Traditional Chinese medicine treatment

近年来，腹腔镜手术在腹部外科领域得到广泛应用，其关键操作一二氧化碳气腹的建立通过向腹腔内注入医用二氧化碳气体创造足够的手术操作空间和清晰视野，显著提升手术安全性与有效性。（剩余7988字）