难治性胃食管反流病中西医治疗现状  

Chinese and western medicine treatment of refractory GERD

作　　者：周鸿[1] 陈鸣艳[1] 吕宾[1] 

机构地区：[1]浙江中医药大学附属第一医院消化科,杭州硕士研究生31006

出　　处：《环球中医药》2011年第1期16-19,共4页Global Traditional Chinese Medicine

摘　　要：难治性胃食管反流病可能与胃酸抑制不充分、非酸反流、食管高敏感性等因素有关。西医通常通过更换质子泵抑制剂、调整质子泵抑制剂剂量或者联用H2受体拮抗剂来有效控制胃酸;通过促进动力、肌松药、黏膜保护剂控制非酸反流;Stretta射频技术、腹腔镜下Nissen胃底折叠术对重症、难治性胃食管反流病也是一种有效的治疗方法。中医辨证论治、专方专药随症加减都取得一定疗效。中医辨证以肝胃不和为最常见证型,治疗以理气、清热两类药物应用最多。针灸治疗特色显著,提供了一种新的选择。中西医结合治疗难治性胃食管反流病因其疗效巩固、不易复发等特点,也取得一定的研究成果。Refractory gastroesophageal reflux disease may be caused by incomplete blockade of gastric proton pumps,nonacidic reflux,esophageal hypersentivity and some other factors.The clinical physicians always control the gastric acid by changing the type of PPIs,adjusting the dose of PPIs or combinating of H2 receptor inhibitors;control the nonacidic reflux with promoting motility drugs,muscle relaxant,mucoprotective drugs;the Stretta procedures,the Nissen fundoplication under the aparoscopic are also effective.The syndrome differentiation of Chinese medicine,and the special prescription and herbs for the disease have obtained a certain effect.Treatment on the Basis of Syndrome Differentiation of TCM,special prescription and herbs,plus minus based on the symptom,they all get certain effect.Disharmony between spleen and stomach is the most common syndrome in TCM differentiation.So on the treatment,the herbs we used mostly is regulating qi flow and clearing heat.The acupuncture therapy is significantly characteristic,and provides a new option.Some progress has been made in combination of traditional Chinese medicine and western medicine for the treatment of refractory gastroesophageal reflux diease

关 键 词：难治性胃食管反流病 中西医治疗 质子泵抑制剂 

分 类 号：R57[医药卫生—消化系统]