A Review of Mechanism Research on Traditional Chinese Medicine Intervention in Gastrointestinal Function Rehabilitation after Gastric Cancer Surgery from the Perspective of the Tongjiang Theory

Abstract

Gastrointestinal dysfunction following gastric cancer surgery is a pivotal clinical challenge affecting patient recovery. Conventional modern medical therapies have certain limitations, while intervention strategies based on the Traditional Chinese Medicine (TCM) “Tongjiang Theory” demonstrate unique advantages through multi-target and holistic regulation. Centering on the principle that “the stomach governs descending and functions harmoniously when unobstructed,” this theory summarizes the core pathogenesis after surgery as “stagnation of qi in the middle energizer and failure of fu-organs to descend,” thereby deriving the intervention principle of “regulating qi and promoting descent” to address the branch and “fortifying the spleen and supporting the healthy qi” to address the root. This article systematically reviews the comprehensive TCM intervention system based on this theory, including pattern-differentiated internal treatments represented by formulas such as Sijunzi Decoction, Banxia Xiexin Decoction, and Chengqi-class prescriptions, as well as characteristic external therapies like acupuncture and Chinese herbal enemas. Modern mechanistic research has revealed the scientific connotation of these interventions from multiple dimensions, primarily involving networked pathways such as regulating the brain-gut axis neuroendocrine function, mitigating systemic and local excessive inflammatory responses, repairing the intestinal mucosal barrier, and regulating microecological balance. This paper posits that the “Tongjiang Theory” provides an excellent theoretical framework for integratively understanding and managing the complex postoperative pathophysiological changes. Future research should focus on conducting high-quality evidence-based studies, deepening integrated multi-omics mechanistic exploration, and promoting its deep integration and innovation with modern enhanced recovery after surgery pathways.