Exploration of the Pathogenesis and Syndrome-Based Treatment of Functional Constipation Based on the Theory of "Heavy Obstruction and Orifice Blockage"

SHI Haoran; LIANG Kexin; ZHI Jing; ZHANG Zhirou; ZHAO Luqing

doi:10.13288/j.11-2166/r.2026.15.013

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Exploration of the Pathogenesis and Syndrome-Based Treatment of Functional Constipation Based on the Theory of "Heavy Obstruction and Orifice Blockage"

更新时间：2026-08-05

- Exploration of the Pathogenesis and Syndrome-Based Treatment of Functional Constipation Based on the Theory of "Heavy Obstruction and Orifice Blockage"
- Journal of Traditional Chinese Medicine Vol. 67, Issue 15, Pages: 1659-1663(2026)
- 作者机构：
  
  首都医科大学附属北京中医医院，北京市东城区美术馆后街23号，100010
- 作者简介：
- 基金信息：
- DOI：10.13288/j.11-2166/r.2026.15.013
  CLC：
- Received：22 March 2026，
  
  Revised：2026-07-14，
  
  Accepted：27 May 2026，
  
  Online First：03 August 2026，
  
  Published：02 August 2026
- 稿件说明：
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师浩然,梁可欣,智菁等.基于“重强窍塞”探析功能性便秘的病机及分型辨治[J].中医杂志,2026,67(15):1659-1663.

SHI Haoran,LIANG Kexin,ZHI Jing,et al.Exploration of the Pathogenesis and Syndrome-Based Treatment of Functional Constipation Based on the Theory of "Heavy Obstruction and Orifice Blockage"[J].Journal of Traditional Chinese Medicine,2026,67(15):1659-1663.
师浩然,梁可欣,智菁等.基于“重强窍塞”探析功能性便秘的病机及分型辨治[J].中医杂志,2026,67(15):1659-1663. DOI： 10.13288/j.11-2166/r.2026.15.013.

SHI Haoran,LIANG Kexin,ZHI Jing,et al.Exploration of the Pathogenesis and Syndrome-Based Treatment of Functional Constipation Based on the Theory of "Heavy Obstruction and Orifice Blockage"[J].Journal of Traditional Chinese Medicine,2026,67(15):1659-1663. DOI： 10.13288/j.11-2166/r.2026.15.013.

摘要

基于李杲“重强”“九窍不通”之论，提出“重强窍塞”的病机观点，认为功能性便秘的核心病机在于脾肺同陷、湿浊壅滞，腑气因之不通。在此框架下，脾虚湿陷为出口梗阻型便秘的主要病机，肺气下陷为慢传输型便秘的关键病机，两种病机兼见则形成混合型便秘。以此为指导，将功能性便秘分为三型辨治：出口梗阻型治以通腑降浊、开窍启闭，方用自拟升陷通窍汤；慢传输型治以宣肺运脾、升陷助运，方用自拟宣肺运脾汤；混合型治以宣肺运脾与升清降浊并举，方用自拟宣运通窍汤，临证尚需结合兼夹证候随证化裁。

Abstract

Based on LI Gao's theory of "heavy obstruction" and "blockage of the nine orifices"， this paper proposes the pathological concept of "heavy obstruction and orifice blockage". It is suggested that the core pathogenesis of functional constipation （FC） lies in simultaneous sinking of spleen and lung， together with accumulation and obstruction of dampness and turbidity， resulting in impaired movement of intestinal

. Within this framework， spleen deficiency with sinking of dampness is considered as the primary pathological mechanism of outlet obstructive constipation （OOC）， while sinking of lung

is regarded as the key mechanism underlying slow transit constipation （STC）. When both pathological mechanisms coexist， mixed constipation （MC） develops. Guided by this theory， FC is classified into three patterns for syndrome-based treatment. OOC is treated by promoting bowel movement， descending turbid pathogens， and opening the orifices to restore function， with self-formulated

Shengxian Tongqiao Decoction

（升陷通窍汤）. STC is treated by diffusing lung

， regulating spleen function， raising sinking

， an

d promoting transportation， with self-formulated

Xuanfei Yunpi Decoction

（宣肺运脾汤）. MC is treated by regulating lung and spleen function， simultaneously raising clear

and descending turbidity， with self-formulated

Xuanyun Tongqiao Decoction

（宣运通窍汤）. In clinical practice， modifications should be made according to accompanying syndromes and individual conditions.

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references

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