基于络病学说论治难治性胃食管反流病  

Treatment of Refractory Gastroesophageal Reflux Disease Based on Collateral Disease Theory

作　　者：苏坤涵 刘万里[1] SU Kunhan;LIU Wanli(Nanjing Integrative Hospital Affiliated to Nanjing University of Chinese Medicine,Nanjing Jiangsu China 210014)

机构地区：[1]南京中医药大学附属南京市中西医结合医院,江苏南京210014

出　　处：《中医学报》2021年第11期2310-2313,共4页Acta Chinese Medicine

基　　金：江苏省中医药局科技重点项目(ZD201805);“十三五”南京市医学科技发展资金重大项目(ZDX16016)。

摘　　要：难治性胃食管反流病病程中,气滞、郁热、痰湿、气虚等病理因素皆可致血行瘀滞,且常相兼为病,致胃络壅塞,进而表现“久病入络”的络病病理特征,可出现病位由浅至深、病邪由气及血导致胃络瘀阻的病理改变。针对本病气滞、郁热、痰湿、气虚与血瘀相兼为病的病机特点,依据络病、腑病皆有“以通为用”的治疗原则,以活血通络、化瘀清络、养血和络为目标,运用行气化痰、泻热祛湿、益气补虚等治法,同时针对瘀血阻络的病机特点,配合活血化瘀、养血生新之品,达到通络、清络、和络的效果。In the course of refractory gastroesophageal reflux disease,pathological factors such as qi stagnation,stagnation of heat,phlegm dampness and qi deficiency can lead to blood stasis,and various pathological factors often lead to diseases and congestion of gastric collaterals,which can show the pathological characteristics of"long illness entering the collaterals",and the pathological changes of the disease location from shallow to deep.Pathogenic factors are transferred from Qifen to Xuefen,resulting in pathological changes of gastric collateral stasis.In view of the pathogenesis characteristics of the disease caused by qi stagnation,stagnation of heat,phlegm dampness,qi deficiency and blood stasis,according to the treatment principle of"dredging for use"for collateral diseases and viscera diseases,aiming at promoting blood circulation and dredging collaterals,removing blood stasis and clearing collaterals,nourishing blood and collaterals,the treatment methods of promoting qi and resolving phlegm,purging heat and removing dampness,supplementing qi and tonifying deficiency are used.At the same time,according to the pathogenesis characteristics of blood stasis blocking collaterals,combined with medicine for promoting blood circulation and removing blood stasis,nourishing blood and generating,the effects of dredging collaterals,clearing collaterals and harmonizing collaterals can be achieved.

关 键 词：难治性胃食管反流病 络病学说 活血化瘀法 行气化痰法 泻热祛湿法 益气补虚法 

分 类 号：R256.3[医药卫生—中医内科学]