Discussion on the Combined Internal and External Treatment of Gastroparesis Syndrome after Gastrointestinal Tumour Surgery Based on the Theory of "Yang Transforms Qi and Yin Forms"

: Based on the theory of "Yang transforming into Qi, Yin transforming into shape ", the article explains its connotation and further discusses the etiology, pathogenesis and treatment strategies of postoperative gastroparesis syndrome (PGS) in gastrointestinal tumors. It is believed that the balance of yin and yang is closely related to the growth and development of the body and its functional activities, and that insufficient "yang to transform qi" and too much "yin to form" are the core pathologies of postoperative gastroparesis syndrome. The treatment points out that warming Yang Qi, dispersing nodules and eliminating stagnation are the key to restoring the good offices function of the spleen and stomach, and combining internal and external treatment with multiple methods to balance Yin and Yang, which provides new treatment ideas to expand the identification and treatment of postoperative gastroparesis syndrome in gastrointestinal tumors.


Introduction
Gastrointestinal tract tumors are common diseases that threaten human life and health, with a proportion of more than 50% in the number of cancer incidence and deaths worldwide [1] .Surgical resection is the main treatment for eradicating GI tumors, but postoperative complications are frequent.Postoperative Gastroparesis Syndrome (PGS) is a common postoperative complication, characterized by non-mechanical delayed gastric emptying, with the main clinical manifestations of epigastric fullness, abdominal pain, nausea, vomiting, and poor appetite, etc.The occurrence of PGS seriously reduces the quality of life of the patients after surgery.Currently, the treatment of PGS is mainly based on conservative treatment in western medicine, including basic treatment such as fasting and gastrointestinal decompression, nutritional support, gastric stimulating drugs, gastroscopy to stimulate the gastric wall, and gastric electrical pacing, etc [2] .However, the efficacy of western medical treatment is limited, the treatment method lacks specificity, the prognosis is poor, and the symptoms are prone to recurrence.Chinese medicine treatment of PGS starts from the overall concept to improve the function of the patient's body, which has certain advantages and characteristics compared with western medicine.

Connotation of "Yang Transforming into Qi, Yin Transforming into Shape"
Yin and yang are the general outline of all things in heaven and earth, and " Yang Transforming into Qi, Yin Transforming into Shape " reveals the unity of yin and yang and the characteristics of mutual root and use.Su wen -yin and yang should be like the great theory of the chapter "cloud" accumulation of yang for the sky, accumulation of yin for the ground, yin static yang agitation, yang born yin long, yang kill yin hide, yang Qi, yin forming".Zhang Jiebin [3] notes: "Yang moves and disperses, so it turns into Qi, and yin is quiet and condenses, so it takes shape".See also "Huangdi Neijing Suwen jiqi" note: "the Lord of the heavens creatures, the Lord of the earth into things.Therefore, the gas of all things Yang, and our gas by the Yang; Yin into the shape of all things, and our shape by the Yin into the " [4] .The above highly summarizes the physiological functions and characteristics of yin and yang, that is, to see the rise, the excitement of the momentum, with warmth, promote the function of generating energy is attributed to the "yang gas"; to see the latent drop, the convergence of the momentum, with cool, moisturizing function, the formation of material is attributed to the "Yin forming The "Yin Forming" is the function of cooling and moisturizing and forming matter.Su Wen -Anger Tong Tian Theory" cloud "yin and yang secret, the spirit is cured; yin and yang away from the decision, the essence of the end"."Yang chemically gas, yin forming", the two interact with each other to level the period, and jointly promote the growth and development of the body and functional activities, if the two are out of balance, it is afraid of getting sick.

Insufficient yang transformation qi and too much yin shaping as the core pathomechanism of postoperative gastroparesis
Su Wen -Anger Tong Tian Theory" contains "Yang Qi, if the sky and the sun, the loss of its place will be folded life and do not shine, so the day run when the sun bright", pointing out that Yang Qi in the human body, such as the sun in the natural world as indispensable, for the energy of the source of the birth of life.However, excessive or insufficient yang gas can cause the balance of yin and yang in the human body to be broken."Jingyue Encyclopedia" day: "gas surplus is fire ...... gas is not enough cold" [5] "Yang Hua Qi" is too much of the internal organs are hyperfunctioning, easy to heat fire, burn liquid consumption of fluids, resulting in "Yin shaping" is not enough; "Yang chemical gas" is not enough to reduce the function of the internal organs, warming, gasification powerless, phlegm and dampness, stasis and turbidity coalescence into accumulation, resulting in "Yin shaping" is more.
In Chinese medicine, PGS can be categorized as "Plankton", "Stomach Reflux" and "Abdominal Pain".The spleen and stomach are the foundation of the later heaven, which is not only responsible for the transportation of water and grains, but also the hub of the whole body's qi.When spleen yang is abundant, gastrointestinal power function is normal, spleen rises and stomach descends, and the transportation of water and grains are compatible with each other, which promotes the orderly operation of the middle jiao function.Li Dongyuan's "Treatise on the Spleen and Stomach" said, "The five viscera are not in harmony, and the nine orifices cannot be blocked, all of which have insufficient yang qi and excess yin qi, so it is said that yang does not prevail over its yin" [6] , emphasizing that due to insufficient yang qi and excess yin qi, tangible earth was generated to fill the nine orifices to make them blocked, and moreover tonifying the middle and benefiting the qi soup was made to assist in the ascension of the yang, which indicated the importance of solidifying the spleen and gastric Yang qi.In patients with PGS, when spleen yang is impaired In patients with PGS, the spleen yang is damaged and insufficient, and the spleen and stomach have no power of transportation, resulting in stagnation and blockage of the middle Jiao, and the yin is knotted in the interior of the body, which leads to this disease.In the early stage of PGS patients, the spleen and stomach were weak, and evil qi was found to be malignant tumors.Cancer venom invaded for a long time, and yang qi was increasingly depleted, and the so-called "qi deficiency is the gradual increase of yang deficiency, and yang deficiency is the extreme of qi deficiency", coupled with the surgical resection, which resulted in a large amount of broken qi and loss of blood, leading to a serious deficiency of "yanghua qi", and a deficiency of cold in the middle jiao.Serious deficiency, cold in the middle jiao, qi powerlessness, phlegm and drink, dampness, stasis and toxicity within the accumulation of each other, resulting in "yin forming" surplus, such as the "Spiritual Pivot -The Beginning of All Diseases," said "the warmth of the gas does not work, condensation of the blood and the implantation of the interior does not dissipate, fluid astringent seepage, and not to go," clinically can be Clinical manifestations may include abdominal fullness and distension, and stomach and epigastric plumpness and fullness.On the contrary, phlegm-dampness, stasis and toxins and other pathological products of yin knot as pathogenic factors, hindering the rise of yang qi, further aggravate the positive deficiency state of the body, and so on and so forth, such as the ring of endless, resulting in the characteristics of PGS lingering knot, difficult to cure the disease.It can be seen that PGS is characterized by a mixture of deficiency and solidity, and the dysfunction mechanism of "yang transforming qi and yin shaping" coincides with the mechanism of "yang transforming qi and yin shaping".Therefore, insufficient "yang transforming qi" and too much "yin molding" are the core pathomechanism of PGS.

Warming and supporting yang qi, dispersing knots and eliminating stagnation as the main clinical strategy
The pathogenesis of PGS is based on the insufficiency of "yang chemistry and qi", and "yin shaping" is too much as the symptom, so the treatment should be warming and dispersing, on one hand, warming the yang to support the correctness, on the other hand, dispersing the knots and eliminating the accumulation, and treating the symptom at the same time in order to balance the imbalance of yin and yang.

Warming the Spleen and Kidney, boosting Yang and transforming Qi to support the right side
For the treatment of postoperative tumors, many scholars of traditional Chinese medicine advocate strengthening the spleen and stomach.According to Prof. Liu Deshan [7] the pathogenesis of postoperative gastric cancer belongs to the deficiency of the root and the standard, so the treatment should be based on the staging and identification of evils and realities, and the method of strengthening the spleen and benefiting the qi should be carried out in order to support the positive and remove the evils, and nourish the positive body and security.Yang deficiency and yin knot is the core pathogenesis of postoperative gastric paralysis, so the treatment should be based on warming and replenishing yang qi to support the positive and get rid of the evil.As PGS progresses, the kidney is gradually damaged in the late stage of the disease, and the physiological structure of the digestive tract is damaged due to the long invasion of cancerous toxins and the trauma of gold blades and instruments, resulting in digestive tract dysfunction, disorders in the elevation of the spleen and stomach, and stagnation and loss of spleen yang.Spleen yang is deficient and unable to transform anger, blood and fluids to nourish the innate kidneys.If the kidney Yang is deficient for a long period of time, the fire of the life gate does not warm the spleen and earth, and a vicious circle of Spleen and Kidney Yang deficiency is formed, in which the Yang does not produce qi, and promotes the powerlessness to further promote the accumulation of phlegm, dampness, stasis, and toxins.Therefore, treatment should be based on warming and tonifying the spleen and kidney yang, while not forgetting to take into account kidney yang, warming and tonifying the spleen and kidney, and supporting yang to transform qi, with the aim of enhancing gastrointestinal motility, and restoring the function of the spleen and stomach in transporting and transforming qi.General symptoms include abdominal distension and vague pain, aggravated by cold, fatigue, lumbar and knee pain and weakness, low food intake and dullness, pale red tongue with white greasy moss, and fine pulse.The basic formula of Radix Rehmanniae Tong can be used, which has the function of warming the kidney and strengthening the spleen, replenishing the deficiency and returning yang, and is a classic formula for warming the middle and dispelling cold, with commonly used medicines such as Radix Rehmanniae Tongue, Radix Astragali, Radix et Rhizoma Drynariae, Cinnamomum Cassiae, Rhizoma Atractylodis Macrocephalae, Radix et Rhizoma Ginseng and Radix Glycyrrhizae.Wu Min et al [8] found that the clinical efficacy of the combination of acupuncture with the addition and subtraction of the Radix Polygoni Multiflori Soup for diabetic gastroparesis of the spleen and stomach yang deficiency type is remarkable, which can accelerate gastric emptying and reduce the level of gastrin.However, in view of the mixed pathomechanism of PGS, it is not advisable to supplement the deficiency with warm tonics in order to prevent the evil realities from being closed up inside and the bulges from becoming more and more obvious, and it should be in accordance with the characteristics of the middle jiao to be adjusted and unobstructed.To balance the problem, supplement the deficiency with warm tonics, and collect and supplement the deficiency and dig out the problem, and it can be supplemented with medicines such as Xiangshu, Chaihu, Muxiang, Chenpi, Poria and Bianxia, as appropriate.

Disperses blood stasis and detoxifies toxins to prevent transformation
The "Medical Description -Medical Traceability -Disease Proverbs" said: "If the qi flows, the blood will flow, if the qi stagnates, the blood will stagnate, but the reason why the qi is stagnant is because the qi is deficient."In patients with PGS, "yanghua qi" is insufficient and weak, and blood stasis occurs when blood is not moving smoothly.On the other hand, the surgical resection process may easily damage the blood channels, resulting in blood overflowing out of the veins, and then blood coagulation and stasis.Although the cancer lesion has been removed, the residual poison is still latent in the organism, and the residual poison is easy to attach to blood stasis, and the stasis and toxic stagnation will be afraid of change, inducing the cancerous poison to re-emerge, and the poisonous poison will flow into the collaterals and invade the surrounding tissues and internal organs, leading to tumor recurrence or metastasis, which is commonly seen as peritoneal metastasis in the late stage of PGS, hepatic metastasis, and so on.Studies have shown that activating blood circulation and removing blood stasis drugs are advantageous therapeutic drugs for anti-tumor metastasis, which can broad-spectrum inhibit tumor metastasis, reduce adverse reactions, enhance the efficacy of chemotherapeutic drugs, and improve the drug resistance of malignant tumor cells [9] .Therefore, the treatment is elected to use the products of activating blood circulation and removing blood stasis, together with clearing heat and removing toxins; if the blood stasis is dispersed, then the evil poison has no attachment, and if the evil poison is cleared, then the blood stasis loses the development of metastasis.Clinically, we can add stasis-eliminating antagonists or pairs of medicines for synergistic effect.Professor Jiang Liangduo [10] often used Jiuxiangwu, Hedgehog Pi and Houpu in the treatment of spleen and stomach diseases.The three medicines are paired together, with a line of qi, a line of stasis dispersal and a line of stasis elimination, which together serve to move qi and activate blood circulation, disperse stasis and pass downward movement, and are mainly used in treating the middle jiao qi stagnation and blood stasis syndrome.Then Angelica Sinensis, Rhizoma Ligustici Chuanxiong and Paeoniae Alba are added to the combination of the three herbs, dispersing blood stasis without harming the proper function, tonifying the blood without stagnation, with the function of nourishing and activating the blood, dispersing blood stasis and relieving pain.Complemented by Semen Aristolochiae, Cimicifuga, and Garcinia Cambogia Root, the three herbs work together to clear away heat and detoxify toxins.Studies have shown that Garcinia cambogia root has remarkable antimalignant tumor efficacy, which can inhibit cancer cell reproduction, induce cancer cell apoptosis and inhibit tumor recurrence and metastasis, and has a wide range of prospects for application in the treatment of malignant tumors of the digestive tract [11] .In the treatment of this disease, our teacher Hui-Jian-Ping often used the formula of strengthening the spleen and benefiting the qi to alternate with the formula of anti-cancer and removing blood stasis, which successively embodied the theoretical basis of "yang transforms qi and yin shapes it" to treat the disease mechanism in which "yang transforms qi" is insufficient and "yin shapes it" is too much.The treatment for the disease mechanism of "Yang transforming Qi" is insufficient and "Yin molding" is too much, and good clinical results have been achieved.It is worth noting that blood circulation and stasis medicines should not be given arbitrarily, and attention should be paid to the review of the body's vitality and the progress of the disease before committing to the treatment, not only to avoid wilful depletion of qi and blood, but also to be skillfully utilized to eliminate stasis and generate new ones.

Resolve phlegm, dispel dampness and smooth the middle Jiao
Dampness for a long time is phlegm, which is foul and sticky in nature, stubborn and changeable, and the disease is lingering and difficult to be cured.PGS patients have insufficient "yang hua qi", deficiency of spleen yang, water and dampness are not transformed to coagulate phlegm, and water and grains are not transported to form accumulation of food, and phlegm and food are agglutinated, which are concentrated in the gastric epigastric region, and then there is abdominal fullness and early satiety, nausea, and anorexia.According to Xu Chuyun [12] , accumulation of phlegm and turbidity, followed by accumulation of toxin, and mutual association of phlegm and toxin induces the production and metastasis of cancer.Phlegm and dampness can produce blood stasis over a long period of time and even form articulation and accumulation in the abdomen, resulting in the confusion of the middle Jiao and the confusion of the clear and turbid, and the formation of a tumor microenvironment with many changes.Therefore, resolving phlegm and dispelling dampness to smooth congestion in the middle Jiao is of great significance to the regression and prognosis of PGS.The Four Medical Cases of the Liu Selection said, "Phlegm is brewed by dampness, and dampness is born from the spleen; if the spleen is healthy, there is no dampness to produce phlegm."If the spleen and soil are healthy, the transportation of water and grains, water and dampness will be in order, and phlegm and dampness will naturally be generated without a source.Therefore, the treatment is to strengthen the spleen and qi, resolve phlegm and dispel dampness, and can use ginseng lingbai juju san as the basic formula plus subtractions.Studies have shown that ginseng lingbaijusan combined with enteral nutrition can more safely and effectively reduce the incidence of gastrointestinal dysfunction. [13]If nausea and vomiting are seen in phlegm-dampness plagued middle jiao, aromatic products can be supplemented.Aromatic medicines are pungent and diffusive, and they can be combined with patchouli, cloves, and sand nuts to stop vomiting while resolving dampness.In addition, the spleen should be accompanied by qi, one to prevent the collection of complementary too much congestion in the middle Jiao, the second to promote the recovery of the function of the spleen to rise the stomach down, can be used with Chen Pi, wood, incense and other drugs as appropriate.

Detoxify the liver to disperse knots
Liver, spleen and stomach work together and participate in the process of digestion and metabolism.When the spleen and stomach are in harmony with each other and the production of water and grain essence is abundant, the liver can be nourished and the liver qi is regulated; when the liver's main function is normal, and the qi of the whole body is smooth, the spleen will rise and the stomach will fall, and the spleen and stomach will be healthy and active.PGS patients' spleen and stomach are impaired after the operation, and the liver loses its moistening and nourishment, and its function of excretion is out of order, and the qi is stagnant, which contributes to the formation of yin knots such as phlegm, dampness, and blood stasis.At the same time, PGS patients are often accompanied by varying degrees of anxiety, depression, emotional disorders through the liver to further the spleen against the stomach, affecting the function of the spleen and stomach, i.e., the "yang transformation of qi" is insufficient, and exacerbate the accumulation of pathological products, i.e., the "yin shaping" is too much.Studies have shown that mental and emotional factors may further trigger gastrointestinal dysfunction by affecting the brain-intestinal axis and intestinal flora [14] Xiong Mingqin [15] administered positive cognitive therapy to elderly patients with PGS and found that the negative emotions of the patients were significantly improved, which indirectly contributed to the alleviation of gastrointestinal symptoms and postoperative recovery of the patients.Therefore, the principle of treatment is to relieve the liver and depression, and regulate qi and dissipate knots, and Chai Hu Shuo Liver San can be used as the basic formula.Huang Yingjie et al [16] treated 57 patients with functional dyspepsia of liver-qi stagnation type with a 4-week course of domperidone combined with Chai Hu Shu Liver San, and the results showed that compared with the domperidone tablets group, the patients' symptoms were effectively improved, the gastrointestinal hormones were significantly improved, and gastric motility was significantly enhanced.At the same time, the emotional guidance for PGS patients should be strengthened to build up the patients' confidence in the treatment in order to improve the therapeutic efficacy.

Characteristic external treatment
The rationale for the treatment of the reasoning of the internal treatment of the reasoning of the external treatment, the external treatment of the drug that the internal treatment of the drug, the difference between the law. [17]" That is, the internal and external treatment method is the same as the end away, with a different side of the same cause of the wonderful.Part of the digestive tract malignant tumor PGS patients are prone to drug refusal after surgery and radiotherapy, which can be assisted by external treatment from the surface of the body.The external treatment of Chinese medicine can relieve the pressure of gastrointestinal tract and reduce the irritation of gastrointestinal tract, which is the characteristic advantageous treatment of Chinese medicine for postoperative gastrointestinal malignant tumors, and the commonly used external treatments include acupoints paste therapy, acupuncture therapy, moxibustion therapy and so on.

Acupoint therapy
The rationale for the boiler parallel text "cloud:" cream can cure the disease, no different from the soup, with the right method, the sound should. [17]"Acupuncture point paste is based on the theory of Chinese medicine meridians and collaterals, through the stimulating effect of drugs and acupoint regulation, in order to dredge the meridians and collaterals, coordination of internal organs, to achieve the purpose of balancing yin and yang.According to the specific pathogenesis of PGS yang deficiency and yin junction, acupoint patch treatment is to warm yang and transform qi, resolve phlegm and dissipate blood stasis, and the medicines used can be selected from dry ginger, cinnamon, Wu Juju, frankincense, myrrh, and half-summertime, etc., with pungent dispersing medicines, such as xinxing and baixin, to accelerate the penetration of medicines into the skin.Shen Yang et al [18] used warming yang and removing blood stasis as the method to formulate "gastroparesis external dressing formula" to treat patients with cold PGS, the experimental group was treated with gastroparesis external dressing formula, and the control group was treated with a placebo drug, and the therapeutic effective rate of the experimental group after 14 days of treatment was up to 68.33%, which was significantly higher than that of the placebo group of 41.67%, with a significant difference (P < 0.05) between the two groups, significant difference (P < 0.05).When applying the patch, the main acupoints of Shenque and Zhongkou are often used, and the points are simple and significant."The Mystery of the Outer Platform" says: "The navel is the palace of the primordial spirit, where the spirit resides and the divine qi is injected.This indicates that the Shenque acupoint is the convergence point of various qi, connecting all the meridians, which means it helps to restore yang energy and nourish the body.In addition, due to the thin skin and rich vascular network around the navel, administering drugs here can speed up their penetration.Meanwhile, the Zhongwan acupoint, as one of the eight convergence points of the internal organs, is also a collecting point of the Stomach meridian.It can treat all diseases of the intestines, and has the effect of removing lumps and stagnation, regulating qi, strengthening the spleen and benefiting the stomach.

Acupuncture therapy
Acupuncture therapy is guided by the theory of traditional Chinese medicine, using specific tonic and diarrhea techniques to stimulate acupoints and meridians to communicate with the internal organs and regulate the whole body's qi and blood to prevent and treat diseases.Clinical treatment of gastrointestinal dysfunction often use acupuncture therapy, which is safe, simple and effective.Studies have shown that acupuncture can improve gastrointestinal function by regulating gastrointestinal hormones, vagus nerve, gastrointestinal flora and other pathways [19] .This disease is based on the imbalance of yin and yang regulation in PGS patients, and acupuncture treatment stimulates the transformation of yin and yang to relative balance, and yin and yang harmonization leads to internal and external communication, orderly elevation and lowering of the qi, and the spleen and stomach naturing and transporting each other.In the treatment, the method of warming yang qi and harmonizing yin and yang is to select the acupoints of Yangming Stomach Meridian and Taiyin Spleen Meridian, in addition to the specific acupoints, taking the main acupoints of Foot Sanli, Sanyinjiao, Zhongkou, Neiguan and Guanyuan.Sun Haojie et al. [20] found that, at present, in the domestic and international acupuncture treatment of PGS, the top three frequency of selected acupuncture points are Foot Sanli, Neiguan, and Zhongkou, and the results of cluster analysis showed that the three are closely related, and they are the core of the acupuncture point prescription.Studies have shown that snap-needle acupuncture at the foot-sanli, Neiguan, and zhong epigastric epigastric epigastric epigastric epigastric points can improve the nausea and vomiting symptoms of patients with gastroenterology more easily and effectively than conventional drug therapy [21] , which shows that the combination of the above three acupoints will also be beneficial for nausea and vomiting in some patients with PGS.

Moxibustion therapy
Introduction to medicine" cloud "medicine is not as good as, the needle is not, must be moxibustion", that moxibustion has acupuncture can not be replaced by the advantages.Moxibustion therapy, refers to the heat, light, smoke effect by virtue of moxibustion, through the stimulation of acupoints, meridians, stimulate the qi and blood, nourish the internal organs, to achieve the purpose of health care and treatment."Moxibustion Jinglun" cloud "the moxibustion from the fire, the fire is hot and fast to the body soft and strong, can eliminate cataracts."Here, the Yin cataract corresponds to the "yin shaping" of this disease, including phlegm, dampness, blood stasis, poison, etc., which are attributes of yin, and through the tonic and warming effect of moxibustion, the body's yang qi is supplemented, and when the "yang chemistry qi" is sufficient, the Yin cataract can be eliminated, and the accumulation of Yin cataracts will be dispersed, so as to improve the symptoms of abdominal distension and abdominal pain.Abdominal distension, abdominal pain and other symptoms.Wang Lu'e et al [22] randomly divided 80 patients with severe gastrointestinal dysfunction into two groups.
The control group received basic Western medical treatment, while the treatment group received moxibustion therapy in addition to the basic treatment.The results showed that the overall response rate in the treatment group was significantly higher than that in the control group, and the recurrence rate was significantly lower than that in the control group.This suggests that moxibustion therapy can stimulate qi and blood through heat to nourish the organs, speed up the recovery of gastrointestinal dysfunction in patients, and improve the quality of life of critically ill patients.

Comprehensive treatment
Su Wen -Different Methods and Formulas" says: "Therefore, the saints combined treatment with each other, so the treatment is different and the disease is cured".Mixed treatment means comprehensive treatment, postoperative gastroparesis is a complex disease, the disease is prolonged and lingering, a single means of treatment is often slow to see the effect, if a variety of therapeutic means of combining, complementing the strengths of the shortcomings of the maximize the therapeutic role, and directly improve the clinical efficacy of the treatment.Treatment should be based on the actual situation of the patient, identification and treatment of the most suitable combination of therapeutic methods.For example, the oral Chinese medicine soup with the medicinal herb Rizhong Tang with the acupoint patch treatment, the implementation of warming yang to support the positive balance, phlegm dispersal of blood stasis in order to get rid of the evil, the internal and external treatment, the symptomatic and the fundamental, for the clinical treatment of PGS to provide a full range of multi-layered ideas.Yang Liangliang et al [23] randomly divided 80 patients with gastroparesis syndrome after abdominal surgery into a treatment group and a control group.On the basis of conventional treatment, the control group was treated with gastrointestinal dynamics drugs, and the treatment group was treated with traditional Chinese medicinal broths combined with acupuncture, and it was found that the treatment group had more gastric drainage flow than the control group, and it could more quickly resume independent feeding and the first defecation, and the effective rate of the treatment group was superior to that of the control group (p < 0.05).(The effective rate of the treatment group was better than that of the control group (p < 0.05).

Conclusion
Based on the theory of "yang transforms qi and yin takes shape" in Huangdi Neijing, combined with the physiological functions of the spleen and stomach, it is believed that insufficient yang transforms qi and too much yin takes shape is the key to the pathogenesis of the disease, and that deficiency of yang qi is the core of PGS, and phlegm, dampness, stasis and stagnation of qi are the key points of the disease mechanism.At present, the Chinese medicine mechanism of PGS has not yet been determined and perfected, and relevant basic research has yet to be confirmed.The theory of "yang transforming into qi and yin shaping into form" provides a guide to syndrome differentiation and treatment of postprandial gastroparesis syndrome (PGS) from the perspective of the holistic concept of traditional Chinese medicine.It aims to restore the motor function of the spleen and stomach as the fulcrum by coordinating the balance of yin and yang, addressing both the root and the symptoms, combining elimination and enhancement, and treating internally and externally, utilising their respective advantages for comprehensive diagnosis and treatment.The ultimate goal is to contribute to the recovery of patients with PGS.