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腹氣脹難癒

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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