关键词: 功能性便秘, 以补开塞, 益气养阴法, 气阴两虚证, 参地儿便舒, 儿童

Abstract:

Pediatric functional constipation(FC) is a common disease in children. Although modern treatments can relieve symptoms in the short term, relapse often occurs after drug withdrawal, and long-term use of laxatives will impair intestinal function. In previous traditional Chinese medicine(TCM) practice, FC was mostly managed from the perspective of "intestinal Qi obstruction", with emphasis on attacking the lower to unblock, while insufficient attention was paid to the pediatric physiological characteristics of "tender Yin and tender Yang and being susceptible to Qi and Yin damage" and the pathogenesis of "constipation due to deficiency". Based on the theory of "treating obstruction with tonification" and taking the physiological and pathological characteristics of children into account, Chief Physician Li Hui proposes the method of "tonifying to relieve obstruction" for the treatment of pediatric FC of Qi-Yin deficiency syndrome. She holds that the core pathogenesis follows the evolution of "excess leading to deficiency--injury of Qi and Yin--deficiency leading to excess", and emphasizes that "replenishing Qi and Yin" is not only the fundamental treatment but also the key to restoring intestinal function of conduction. The therapeutic principles established in clinical practice are "replenishing Qi and nourishing Yin to consolidate the root, combining tonification with unblocking to regulate the manifestation, and seeking Yin within Yang to stabilize the pivot"; hence, the empirical formula "Shendi Erbian Shu" has been developed. The paper systematically expounds her academic thoughts from the aspects of pathogenesis evolution, theoretical connotation, prescription compatibility and typical cases, aiming to provide new clinical ideas for the TCM treatment of pediatric FC of Qi-Yin deficiency syndrome.

Key words: Functional constipation, Tonifying to relieve obstruction, Supplementing Qi and nourishing Yin, Qi-Yin deficiency syndrome, Shendi Erbian Shu, Child