[1]顾世坦,周正华,冀建斌,等.胃食管反流病中医辨治探析[J].陕西中医,2022,(8):1078-1081.[doi:DOI:10.3969/j.issn.1000-7369.2022.08.022]
 GU Shitan,ZHOU Zhenghua,JI Jianbin,et al.Discussion on treatment of gastroesophageal reflux disease by traditional Chinese medicine[J].,2022,(8):1078-1081.[doi:DOI:10.3969/j.issn.1000-7369.2022.08.022]
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胃食管反流病中医辨治探析
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《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2022年8期
页码:
1078-1081
栏目:
学术探讨
出版日期:
2022-08-05

文章信息/Info

Title:
Discussion on treatment of gastroesophageal reflux disease by traditional Chinese medicine
作者:
顾世坦周正华冀建斌王 威
(天津中医药大学第一附属医院 国家中医针灸临床医学研究中心,天津 300380)
Author(s):
GU ShitanZHOU ZhenghuaJI JianbinWANG Wei
(First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300380,China)
关键词:
胃食管反流病 湿热蕴结 脾虚气滞 湿阻三焦 肝郁气逆 温胆汤
Keywords:
Gastroesophageal reflux disease Damp-heat accumulation Spleen deficiency and qi stagnation Wet resistance trifocal Liver qi depression Wendan decoction
分类号:
R 573
DOI:
DOI:10.3969/j.issn.1000-7369.2022.08.022
文献标志码:
A
摘要:
探讨“常法与变法”在胃食管反流病(GERD)中的具体临床应用。GERD致病原因复杂,其基本病机为脾虚失运为本,肝郁气逆为标,二者互相影响,治疗时常需兼顾常法与变法。常法有四,即辨证为湿热蕴结证时,选用温胆汤合菖蒲郁金汤加减以清热化湿开窍; 辨为脾虚气滞证时,用香砂六君子汤合平胃散加减以健脾燥湿行气; 邪气弥漫,辨为湿阻三焦证时,则用三仁汤加减以宣通三焦利湿; 中年女性,辨为肝郁气逆证时,选用柴胡加龙骨牡蛎汤加减以疏肝和胃降逆。在此基础上随症加减,有是症,用是药。中医学强调整体观念,故以通心阳、清心火、调肺气、滋肾阴为治疗之变法,且注重患者自身调护,以减少复发,提高临床疗效。
Abstract:
Investigating the clinical application of “routine method and variant method ” in gastroesophageal reflux disease(GERD).The pathogenesis of GERD is complex.The basic pathogenesis of GERD is spleen deficiency and dysfunction,and liver qi stagnation.Both of them affect each other.The treatment often needs to take into account the conventional and modified methods.There are four common methods,that is,when syndrome differentiation is damp-heat accumulation,Wendan decoction and Changpu Yujin decoction are used to clear heat and remove dampness.When the syndrome of spleen deficiency and qi stagnation is identified,Xiangsha Liujunzi decoction combined with Pingwei powder is used for invigorating spleen,drying dampness and promoting qi; when the evil is diffuse and is identified as dampness obstructing Sanjiao,Sanren decoction is used to remove dampness.Middle-aged women,when identified as liver qi depression,choose Chaihu Longgu Muli decoction to soothe liver and stomach.On this basis,the dialectical addition and subtraction of drugs.Traditional Chinese medicine emphasizes the holistic concept,so it takes tongxinyang,clearing heart fire,regulating lung qi,nourishing kidney yin as the treatment methods,and pays attention to the patient's own care,in order to reduce recurrence and improve clinical efficacy.

参考文献/References:

[1] 中华医学会消化病学分会.2020年中国胃食管反流病专家共识[J].中华消化杂志,2020,40(10):649-663.
[2] 李芳芳,黄巨霞.雷贝拉唑联合莫沙必利对反流性食管炎患者幽门螺杆菌感染及炎症因子水平影响研究[J].陕西医学杂志,2019,48(10):1378-1380.
[3] 李吉梅.埃索美拉唑治疗反流性食管炎75例临床观察[J].陕西医学杂志,2017,46(9):1286-1288.
[4] 乔 刚,赵宏志.胃食管反流病临床研究进展[J].中国中西医结合外科杂志,2020,26(4):787-789.
[5] 张声生,朱生樑,王宏伟,等.胃食管反流病中医诊疗专家共识意见(2017)[J].中国中西医结合消化杂志,2017,25(5):321-326.
[6] 钟洁媚,吕 雄,曾凤珊,等.基于“气血肝脾”理论论述吕雄教授治疗良性甲状腺结节经验[J].陕西中医,2022,43(2):240-243.
[7] 张 羽,黄美祯,潘春曲,等.谢胜名中医从三焦论治胃食管反流病经验[J].陕西中医,2022,43(1):100-103,136.
[8] 李高见,张声生,刘婉琼.张声生教授从气机升降角度治疗胃食管反流病经验[J].中国中西医结合消化杂志,2020,28(4):312-315.
[9] 陈梦玲,屈银宗.香砂六君子汤加减联合西药治疗脾胃虚弱型反流性食管炎临床观察[J].山西中医,2022,38(2):27-29.
[10] 赵菁莉,赵 晰,黄文政,等.黄文政教授应用乌贝散治疗慢性胃病验案两则[J].天津中医药,2021,38(11):1361-1363.
[11] 陈晶晶,张文风,张茂云,等.治疫经方三仁汤证治规律浅析[J].长春中医药大学学报,2022,38(2):123-126.
[12] 杨荣禄,刘兰林,杨亚平,等.刘兰林教授运用三仁汤化裁论治三焦湿热证经验[J].浙江中医药大学学报,2015,39(9):689-691.
[13] 王红霞,魏景景,康洪昌,等.柴胡加龙骨牡蛎汤治疗消化心身疾病体会[J].环球中医药,2018,11(1):73-75.
[14] 陈 明.柴胡加龙骨牡蛎汤证解读及运用[J].中华中医药杂志,2015,30(10):3420-3422.
[15] 许科斌.黛力新联合奥美拉唑治疗慢性胃炎伴反流性食管炎的效果研究[J].中国社区医师,2022,38(3):49-51.
[16] 王桂娟,刘福晓,龚 丽,等.柴胡加龙骨牡蛎汤治疗少阳郁火型消渴郁证的疗效观察[J].广州中医药大学学报,2021,38(12):2577-2585.
[17] 张 博,李 乔,谢冰昕.左金丸治疗对肝火犯胃证反流性食管炎患者胃肠道自主神经功能的影响[J].世界中医药,2018,13(4):830-833.
[18] 汪忠镐,吴继敏,胡志伟,等.中国胃食管反流病多学科诊疗共识[J].中国医学前沿杂志:电子版,2019,11(9):30-56.
[19] 李 慧.张锡纯阐发中医藏象理论发微[J].浙江中医药大学学报,2019,43(11):1230-1232.
[20] 赵智宏,徐 杰.从中医脏腑八纲辨证理论探讨胃食管反流病的病机及治疗方法[J].陕西中医,2019,40(4):515-518.

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备注/Memo

备注/Memo:
基金项目:国家重点研发计划项目(2019YFC1709604)
更新日期/Last Update: 2022-08-10