肝胃不和胃脘痛辨治经验  

Experience in differentiating and treating gastric duct pain with liver and stomach disharmony

作　　者：周永学[1] ZHOU Yongxue(Shaanxi University of Chinese Medicine,Xianyang 712046,China)

机构地区：[1]陕西中医药大学,陕西咸阳712046

出　　处：《陕西中医》2024年第9期1241-1244,共4页Shaanxi Journal of Traditional Chinese Medicine

基　　金：陕西省中医药管理局项目(SZY-YLKYC-2018)。

摘　　要：胃脘痛包括现代医学的各种急慢性胃炎和消化性溃疡,是消化系统常见病、多发病。在中医学藏象学说和病因病机理论中,肝胃不和是导致胃脘痛发作的主要病机之一,若肝的疏泄功能失职,导致气滞、气郁、化火、克脾等皆可直接或间接影响胃之通降,形成肝病及胃或肝胃同病,均可导致胃脘痛。笔者根据肝胃不和的临床表现将肝胃不和病机归纳总结为肝气郁结、胃失和降,肝郁化火、肝胃郁热,肝郁气滞、肝胃阴虚,肝胃气滞、气滞血瘀,肝郁脾虚、胃失和降,胆胃不和、气逆不降,胆胃郁热、痰湿中阻7个证型。现就肝胃不和辨证和治法方药进行梳理分析,以期对临床辨治胃脘痛有一定的借鉴。Epigastric pain,including various acute and chronic gastritis and peptic ulcer in modern medicine,is a common and frequently-occurring disease of digestive system.In the theory of traditional Chinese medicine and the theory of etiology and pathogenesis,the disharmony between liver and stomach is one of the main pathogenesis leading to the onset of epigastric pain.If the liver fails to discharge its functions,leading to qi stagnation,qi depression,fire,spleen inhibition,etc.,can directly or indirectly affect the gastric flow down,forming liver disease and stomach or liver and stomach disease,which can lead to epigastric pain.According to the clinical manifestations of liver and stomach disharmony,the pathogenesis of liver and stomach disharmony is summarized as liver qi stagnation and stomach disharmony.Liver depression turns fire,liver and stomach depression heat;Liver-qi stagnation,liver-stomach Yin deficiency;Liver and stomach qi stagnation,qi stagnation blood stasis;Liver depression and spleen deficiency,stomach disharmony;Gallbladder and stomach disharmony,qi reverse does not fall;Gallbladder and stomach stagnation heat,phlegm dampness blockage 7 syndrome types.In this paper,the differentiation of liver and stomach disharmony and the treatment methods and prescriptions were combed and analyzed,in order to have some reference for clinical differentiation and treatment of stomach duct pain.

关 键 词：胃脘痛 肝气郁结 肝胆郁热 脾气虚弱 胃失和降 辨证论治 

分 类 号：R573[医药卫生—消化系统]