最為家傳戶曉的《伊索寓言》故事,莫過於「青蛙和牛」。青蛙因想與牛較量,所以鼓起腹部,但結果腹脹得並不好受,悔疚不已。在現實生活中,我們當然不會與人比較腹大便便,但其實不少人常受腸胃氣脹困擾,難以消除。以下將介紹其成因及解決辦法。
腹部氣脹有上腹部脹或腹中央肚臍處脹之分。兩者實際受影響器官及成因並不盡相同:上腹脹滿因胃內空氣停滯所致;腹臍處則因腸內食物消化不良或殘餘物停留,或者便秘產生氣體所引起。
中醫認為胃與腸為六腑器官,其結構特徵為內裏中空通道,功能「轉化物而不藏」,並以通暢為良,所以食物液體並不應停留胃腸道,理應順利消化後排出體外。但當外在因素例如過度受冷吹風或久處濕熱環境,內因飽食過度、情緒抑鬱或緊張影響,甚至因腸胃炎等疾病,引致胃功能失調、胃氣不降,所以胃脘脹滿。而大小腸氣脹成因多因過食無度,或腸臟積熱,並致大便秘結,矢氣臭穢難聞,症伴見大便乾結或黏稠不暢。
要解脹氣,首要條件是分清胃或大小腸病患位置。若胃犯病者,其氣脹位於肚臍以上,治理要除針對症狀外,要辨清疾病本因,一併處理。例如腸胃炎可處方藿香正氣散加減,飲食過度致病者服用保和丸加減,感冒後期者小柴胡湯,情緒起伏影響胃氣脹者,則以逍遙散為主方,各情況皆可輔以平胃散助消除氣脹。另一方面,大小腸氣脹及便秘,則宜適當瀉下以通腸洩穢,可適量服用火麻仁茶或草決明茶,有助盡快排泄產生氣體的宿便。
另一邊廂,病後亦應清淡飲食,遠離辛辣油膩及煎炸食物,同時要減少進食容易產生氣體或難消化食物,例如豆類、蘋果或過量肉食。而要減低復發,就必須同時針對疾病及症狀,適時戒口,切不能單純反覆去除氣體,否則症狀難癒。
原文刊登於2021年6月9日《香港經濟日報》理療感悟,標題為"腹氣脹難癒?"
撰文 : 盧文健 物理治療師、註冊中醫師
欄名 : 理療感悟
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