基于“心胃相关”理论探析胃食管反流病相关性胸痛病机  

Analysis of Pathogenesis of Chest Pain Related to Gastroesophageal Reflux Disease Based on"Heart Stomach Correlation"Theory

作　　者：罗楠 王少丽[1] 李萌[1] 姜天童 刘震[1] LUO Nan;WANG Shaoli;LI Meng;JIANG Tiantong;LIU Zhen(Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China)

机构地区：[1]中国中医科学院广安门医院,北京100053

出　　处：《中国中医基础医学杂志》2024年第4期607-610,共4页JOURNAL OF BASIC CHINESE MEDICINE

基　　金：吴阶平医学基金会临床科研专项(320.6750.2021-04-31)。

摘　　要：胃食管反流病是临床上一种常见的疾病,胃食管反流病相关性胸痛是非心源性胸痛最常见的食管源性病因,与心血管系统疾病有关胸痛极易混淆,在临床上需认真鉴别,以便明确诊疗。心与胃位置相邻,经络相通,生理与病理上相互联系,心在脾胃病的辨证论治中具有重要作用。“心胃相关”理论为胃食管反流病相关性胸痛提供了理论基础。脾胃虚弱,推动无力,气血生化乏源,心失所养;脾虚,肝木乘克脾土,肝胃不和,气郁日久,郁而化热,热扰心神,胃气挟火热上逆,日久耗伤阴血。因虚致瘀或气滞血瘀,不通则痛,胸脉瘀阻,引起胸痛。本文基于“心胃相关”理论从“虚、郁、瘀”角度出发,探讨胃食管反流病相关性胸痛,为临床诊疗提供更好的思路。Gastroesophageal reflux disease(GERD)is a common disease in clinical practice.As the most common esophageal cause of non-cardiogenic chest pain,GERD-related chest pain,which is easily confused with cardiovascular system diseases,needs to be distinguished carefully in clinical practice to clarify diagnosis and treatment.The heart is adjacent to the stomach,with interconnected meridians and physiological and pathological connections.The heart plays an important role in the diagnosis and treatment of spleen and stomach diseases.The theory of"heart-stomach correlation"provides a theoretical basis for GERD associated with chest pain.Because the spleen and the stomach are too weak to drive,Qi and blood are so deficient that heart loses its nourishment;due to insufficiency of the spleen,the liver wood over-restrains the spleen earth,liver-stomach disharmony appears,Qi stagnation persists for a long time,stagnation is transformed into heat,heat disturbs the mind and spirit,and stomach Qi carrying fire and heat reverses upward,consuming Yin and blood over time;Stasis caused by deficiency or Qi stagnation and blood stasis pain occurs when there is no obstruction,chest vessel obstruction causes chest pain.Based on the theory of"heart-stomach correlation"and from the perspective of"deficiency stagnation",this paper will discuss the chest pain associated with GERD and provide better ideas for clinical diagnosis and treatment.

关 键 词：胃食管反流病相关性胸痛 心胃相关 虚 郁 瘀 

分 类 号：R259[医药卫生—中西医结合]