基于胃强脾弱论治难治性胃食管反流病  

Treatment of Refractory Gastroesophageal Reflux Disease from Stomach Exuberance and Spleen Deficiency

作　　者：张励航 窦丹波[1] ZHANG Li-hang;DOU Dan-bo(Department of Traditional Medicine,Shuguang Hospital Affiliatedto Shanghai University of Traditional Chinese Medicine,Shanghai 201203)

机构地区：[1]上海中医药大学附属曙光医院传统医学科,上海201203

出　　处：《世界中西医结合杂志》2023年第6期1253-1256,共4页World Journal of Integrated Traditional and Western Medicine

基　　金：上海市进一步加快中医药事业发展三年行动计划[编号:ZY(2018-2020)-GJHZ-1001]。

摘　　要：难治性胃食管反流病(Refractory gastroesophageal reflux disease, RGERD)属于中医学“反酸”“嘈杂”“反胃”等范畴。综合分析历代文献和医家观点,胃强脾弱病机重点在于胃热脾虚,即胃火亢盛而脾气虚弱。从RGERD相关症状、发病机制出发,分析其中医证候及病机,认为脾弱是RGERD发病的基础,进而可以导致气滞、湿阻、郁火等各种情况,最终造成胃强脾弱的病机特点。调和脾胃当为其主要治疗原则,辛开苦降为主要治法。Refractory gastroesophageal reflux disease(RGERD)is a disease of acid reflux,noisy,and nausea in traditional Chinese medicine.A comprehensive review of literature and opinions of physicians suggests that the pathogenesis of stomach exuberance and spleen deficiency lies in stomach heat and spleen deficiency,i.e.,exuberance of stomach fire and deficiency of spleen qi.This study comprehensively considers the symptoms,syndromes,and pathogenesis of RGERD,and concludes that spleen deficiency is the root cause of the disease.Spleen deficiency can lead to qi stagnation,dampness obstruction,and stagnant fire,eventually resulting in stomach exuberance.Harmonizing spleen and stomach should be the main principle to be followed in the treatment of RGERD,and pungent dispersing and bitter descending can be adopted as the main treatment method.

关 键 词：难治性胃食管反流病 胃强脾弱 调和脾胃 

分 类 号：R571[医药卫生—消化系统] R573[医药卫生—内科学]