运脾和胃、辛开苦降法治疗脾虚湿热型胃食管反流病  

Spleen-Activating and Stomach-Harmonizing,Acrid-Release and Bitter-Downbearing Therapy to Treat Gastroesophageal Reflux Disease with Spleen Deficiency and Dampness-Heat Syndrome

作　　者：李红艳 孙志广[2] LI Hongyan;SUN Zhiguang(The Second Afiliated Hospital of Nanjing University of Chinese Medicine,Jiangsu Nanjing 210017,China;Nanjing University of Chinese Medicine,Jiangsu Nanjing 210023,China)

机构地区：[1]南京中医药大学第二附属医院,江苏南京210017 [2]南京中医药大学,江苏南京210023

出　　处：《中国医药导刊》2024年第2期176-180,共5页Chinese Journal of Medicinal Guide

摘　　要：胃食管反流病是由多种致病因素共同作用引起的一种消化道疾病,以反酸、烧心为主症,发病机制较为复杂,病程缠绵难愈,治疗难度较大。脾虚湿热型作为本病常见的证候类型,病因病机复杂,总体以脾胃虚弱为根本原因,湿热内蕴为标。发病的病机关键为气机失调、胃失和降,脾气不升,胃气不降,日久脾虚,湿热内生。临床上常以中西医结合共治此病,可获得较显著疗效。中医治疗常以调畅气机、运脾和胃、辛开苦降为主,用药大多以补气药、理气药及清热药为主,通补兼施,补而不滞,和法缓治,总体以调畅气机为要,以四君子汤合清胃散为基本方进行加减。本研究从脾虚湿热型胃食管反流病的病因病机、辨证要点、治法方药等方面进行总结,并附验案1则佐证,以期为中医药治疗该病提供临床经验及参考。Gastroesophageal reflux disease(GERD)is a gastrointestinal disease that is caused by a variety of pathogenic factors.It is often with acid reflux and heartburn as the main symptoms,the pathogenesis is relatively complex,the course of the disease is long,and the treatment is more difficult.As a common syndrome type of this disease,spleen deficiency and dampness-heat syndrome GERD has a complex etiology and pathogenesis,with the weak spleen and stomach as the root cause and dampness-heat as the symptom,and the key pathogenesis is the disorder of Qiji,failure of stomach Qi to descend,the failure of the spleen Qi to rise,the failure of gastric Qi to fall,and the deficiency of the spleen over a long period of time,which leads to the emergence of dampness-heat.It is often treated with a com-bination of Chinese and western medicine in clinic,which can obtain significant therapeutic effects.Chinese medicine treatment is often based on regulating Qiji,spleen-activating and stomach-harmonizing,acrid-release and bitter-downbearing,and most of the medicines used are Qi invigorating drugs,Qi regulating drugs and heat-clearing drugs.They are applied combination of dredging and tonifying method,supplement and not sluggish,harmonizing and mild therapeutic method.Generally speaking,it is necessary to regulating Qi movement.This study summarizes the etiology and pathogenesis,syndrome differentiation factors,treatment prescriptions and other aspects of GERD with spleen deficiency and dampness-heat syndrome,and uses one experimental case to support the evidence for the clinical experience,in order to provide reference of traditional Chinese medicine treatment of this disease.

关 键 词：胃食管反流病 脾虚湿热 运脾化湿 辛开苦降 

分 类 号：R259[医药卫生—中西医结合]