通讯作者: 陈萌, 187362783@qq.com

DOI：10.12201/bmr.202607.00045

Exploring the Treatment of Chronic Slow Transit Constipation in the Elderly Based on the Theory of “Sweet-Flavored Medicinals Retaining and Restoring Body Fluid”

• 摘要：慢传输型便秘（slow transit constipation,STC）是老年人群常见的功能性胃肠病。老年STC以脾肾亏虚为本、津亏肠燥为标，病程迁延则因虚致瘀，终成本虚标实、虚实夹杂之复合病机。本文基于叶天士“甘守津还”理论，系统探讨老年STC的病机演变与治疗思路。此法虽源于温病胃燥气伤之治，然其“守中复津”之中心思想与老年STC的病机演变高度契合。据此构建以“甘”为轴心，寓通于补，以缓济急之法，使“补中焦、通瘀络、调和阴阳”贯穿始终。现代医学从线粒体能量代谢、水通道蛋白调控、微循环改善及“脑-肠-菌”轴调节等层面为上述治法提供了客观依据，为机体功能减退、不耐攻伐的老年患者提供了一种更为安全、持久的治疗策略。

  关键词： 甘守津还；慢传输型便秘；津亏肠燥；因虚致瘀；; ; ; 

   

  Abstract: Slow transit constipation (STC) is a common functional gastrointestinal disorder in the elderly population. In elderly patients, STC is rooted in deficiency of the spleen and kidney, with intestinal dryness due to fluid depletion as its manifestation. As the disease progresses, deficiency gives rise to stasis, ultimately leading to a complex pathogenesis of combined deficiency and excess, with both root deficiency and surface excess. This article systematically explores the pathogenesis evolution and therapeutic rationale for elderly STC based on Ye Tianshi’s theory of Gan Shou Jin Huan (sweet-flavored herbs to secure the middle and restore fluids). Although this therapeutic approach originates from the treatment of gastric dryness and qi injury in warm diseases, its core principle of “securing the middle to restore fluids” is highly consistent with the pathogenesis evolution of elderly STC. Accordingly, we propose a therapeutic strategy centered on “sweet” flavor, which supplements while promoting unblocking, and uses mild measures to address urgent conditions, thereby integrating “tonifying the middle, unblocking stasis in the collaterals, and harmonizing yin and yang” throughout the treatment course. Modern medicine provides objective evidence for the above therapeutic measures from aspects of mitochondrial energy metabolism, aquaporin regulation, microcirculation improvement, and the brain-gut-microbiota axis regulation. This approach offers a safer and more sustainable treatment strategy for elderly patients with declining bodily functions who cannot tolerate aggressive therapies.

  Key words: Sweet-flavored medicinals for guarding the middle and restoring fluids; Slow transit constipation; Fluid depletion and intestinal dryness; Asthenia leading to blood stasis

  提交时间：2026-07-27

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• 序号	提交日期	编号	操作
  1	2026-07-13	10.12201/bmr.202607.00045V1	下载

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