关键词: 功能性便秘, 中医辨证, 小儿推拿, 脾虚, 脑-肠轴

Abstract:

Based on the core pathogenesis of "spleen deficiency as the root， stagnant heat as the manifestation"， and in combination with the "brain-gut axis" theory， the paper explores the traditional Chinese medicine(TCM) syndrome-differentiated approach to pediatric functional constipation(FC) and the clinical application value of pediatric Tuina. The disease location of pediatric FC is in the large intestine and is closely related to the functions of the spleen， liver， lung， kidney， and "brain spirit". The core pathogenesis involves spleen deficiency with impaired transportation and stagnation of Qi flow， which， over time， may be accompanied by the accumulation of food and internal heat， forming a syndrome characterized by deficiency in root and excess in manifestation. Pediatric Tuina follows the principle of activating spleen and unblocking Fu-organs， regulating the mind and relieving stagnation， employing core manipulations such as tonifying spleen-meridian， clearing large intestine， rubbing abdomen， massaging Tianshu， pushing downward on Qijiegu(the seven-bone line)， and pinching spine, which exerts a comprehensive therapeutic effect through four aspects: physical stimulation， neural regulation， neuro-endocrine regulation， and psychological regulation. The method can reduce long-term recurrence rates and regulate the emotional state of affected children. Based on the holistic concept and the syndrome-differentiated approach of "synchronous brain-gut regulation"， pediatric Tuina has the advantages of safety， effectiveness， and good compliance， making it an important means in the comprehensive treatment system for pediatric functional constipation， which is worthy of clinical promotion and application.

Key words: Functional constipation, Traditional Chinese medicine syndrome differentiation, Pediatric Tuina, Spleen deficiency, Brain-gut axis