从逆、热、郁探讨经方在胃食管反流病中的运用  

Discussion on Application of Classic Formulas in Treating Gastroesophageal Reflux Disease from Aspects of Counterflow,Heat and Depression

作　　者：唐可伟 周秉舵[2] 李亚鼎 刘晓文 许高凡 何聪 王轶[2] 徐亭亭[2] 邓玉海[2] 朱生樑[2] TANG Kewei;ZHOU Bingduo;LI Yading;LIU Xiaowen;XU Gaofan;HE Cong;WANG Yi;XU Tingting;DENG Yuhai;ZHU Shengliang(Ningbo Haishu District Hospital of Traditional Chinese Medicine,Ningbo Zhengjiang 315012,China;Department of Gastroenterology,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China)

机构地区：[1]宁波市海曙区中医医院,浙江宁波315012 [2]上海中医药大学附属岳阳中西医结合医院消化科,上海200437

出　　处：《新中医》2024年第2期32-37,共6页New Chinese Medicine

基　　金：国家自然科学基金面上项目(81973809);上海市卫健委-朱生樑上海市名老中医学术经验研究工作室项目(SHGZS-202203);2021年浙江省中青年临床名中医项目培养对象项目(浙中医药〔2021〕22号)。

摘　　要：胃食管反流病与《伤寒杂病论》中部分方证相近,表现出“逆、热、郁”的病机特点。以“逆”为病机的证型有气虚痰逆、阴虚气逆、脾伤饮逆、肝寒浊逆等4型,旋覆代赭汤、麦门冬汤、苓桂术甘汤、吴茱萸汤等方分别治之;以“热”为病机的证型有热郁胸膈、上热下寒等2型,栀子豉汤、黄连汤等方分别治之;以“郁”为病机的证型有邪郁少阳、痰(水)气互阻、痰热互结、阳微阴弦等4型,小柴胡汤、半夏厚朴汤(射干麻黄汤)、小陷胸汤、枳实薤白桂枝汤等方分别治之。应用仲景学说的相关思想可以指导胃食管反流病的治疗。Gastroesophageal reflux disease(GERD) is similar to some formula syndromes in Shang Han Za Bing Lun(Treatise on Cold Damage and Miscellaneous Diseases),showing the pathogenesis of "counterflow,heat and depression".The syndromes of "counterflow" as the pathogenesis include qi deficiency and phlegm counterflow,yin deficiency and qi counterflow,spleen damage and rheum counterflow,and liver cold and turbidity counterflow,which are treated by Xuanfu Daizhe Decoction,Maimendong Decoction,Linggui Zhugan Decoction and Wuzhuyu Decoction respectively.The syndromes of "heat" as the pathogenesis include heat obstructing the chest and diaphragm,and upper cold and lower heat,which are respectively treated by Zhizichi Decoction and Huanglian Decoction.The syndromes of "depression" as the pathogenesis include pathogenic factors obstructing shaoyang,mutual obstruction of phlegm(water) and qi,binding of phlegm and heat,and weak pulse at yang and wiry pulse at yin,which are respectively treated by Xiaochaihu Decoction,Banxia Houpo Decoction(Shegan Mahuang Decoction),Xiaoxianxiong Decoction and Zhishi Xiebai Guizhi Decoction.The application of ZHANG Zhongjing's theory can guide the treatment of GERD.

关 键 词：胃食管反流病 《伤寒杂病论》 逆 热 郁 方证运用 

分 类 号：R571[医药卫生—消化系统]