从NMDA信号通路探析疏肝和胃法在难治性胃食管反流病中的应用  

Application of Soothing Liver and Harmonizing Stomach on GERD Based on NMDA Signaling Pathway

作　　者：王轶[1] 朱生樑[1] 方盛泉[1] 周秉舵[1] WANG Yi;ZHU Shengliang;FANG Shengquan;ZHOU Bingduo(Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院,上海200437

出　　处：《中医药学报》2022年第12期111-115,共5页Acta Chinese Medicine and Pharmacology

基　　金：国家自然科学基金青年科学基金项目(82004324);上海市青年科技英才扬帆计划项目(20YF1450700);上海中医药大学预算内项目(2020LK055);上海中医药大学“杏林中青年人才”培养项目;上海市“科技创新行动计划”临床医学领域项目(19401971800);上海市卫健委卫生行业临床研究专项(202140171);上海市进一步加快中医药传承创新发展三年行动计划--胃食管反流病中医专病联盟建设(ZY〔2021-2023〕-0302)。

摘　　要：食管内脏高敏感是胃食管反流病的治疗难点。西医学认为食管内脏高敏感是中枢及外周神经系统对感觉传导功能的调控失常导致的,NMDA信号通路参与了食管正常感知阈的维持,其异常与食管高敏感密切相关。中医学认为“肝失疏泄”是胃食管反流病发病的始动因素,疏肝和胃法在改善难治性胃食管反流病患者食管高敏感状态方面有较高的临床应用价值。Esophageal visceral hypersensitivity is a difficult point in treatment of gastroesophageal reflux disease(GERD).Modern medicine believes that esophageal visceral hypersensitivity is caused by the abnormal regulation of central and peripheral nervous system on sensory conduction.NMDA signaling pathway is involved in the maintenance of esophageal normal perception threshold,and its imbalance is closely related to esophageal hypersensitivity.TCM believes that‘Liver failing in dispersing’is the initial factor of GERD.The method of soothing Liver and harmonizing Stomach has a high clinical value in improving the esophageal hypersensitivity of the patients with refractory GERD.

关 键 词：难治性胃食管反流病 食管高敏感 NMDA 疏肝和胃 

分 类 号：R259[医药卫生—中西医结合]